title: Burst Spinal Cord Stimulation in a Patient with Complex Regional Pain Syndrome: A 2-year Follow-Up.
abstract: Spinal cord stimulation (SCS) is an effective therapy to treat most patients with complex regional pain syndrome (CRPS); however, the effect is not always maintained over time. We present a case report of a patient successfully treated with burst SCS after a diminishing effect of conventional tonic stimulation. Burst stimulation is a novel method of SCS consisting of delivering 5 spikes at 500 Hz, 40 times/s (pulse width 1 mseconds). The current output is set to a subthreshold level for paresthesia in the supine position.
  
  
  METHODS
  A 65-year-old woman with CRPS in the left upper extremity experienced a diminishing effect of conventional tonic SCS over time, resulting in an increase of pain with a mean Numerical Rating Score (NRS) of 8. After treatment with burst SCS, the NRS declined to 2 and remained at that level for 2 years. An intermediate/brief period, due to increased CRPS activity, resulted in a higher pain score, which was successfully managed by increasing the burst stimulation to a higher level of subthreshold stimulation.
  
  
  CONCLUSIONS
  In this patient with CRPS, burst SCS was successful in reducing pain scores that could no longer be achieved with conventional tonic stimulation. It appears that pain reduction with burst SCS can be sustained for a relatively long period of time.
authors: Center for Pain Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors: Nadia
authors: http://orcid.org/0000-0002-0276-1511
authors: N
authors: Kriek
authors: Center for Pain Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors: George
authors: G
authors: Groeneweg
authors: Center for Pain Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors: Frank J P M
authors: FJ
authors: Huygen
mesh_terms: D000368:Aged; D020918:Complex Regional Pain Syndromes / Q000628:therapy*; D005260:Female; D006801:Humans; D062187:Spinal Cord Stimulation / Q000379:methods*
keywords: burst stimulation; complex regional pain syndrome; pain; paresthesia; spinal cord stimulation; tonic stimulation