title: High-Frequency Spinal Cord Stimulation in Surgery-Naïve Patients-A Prospective Single-Center Study.
abstract: BACKGROUND
  A multitude of evidence supporting the beneficial effects of spinal cord stimulation (SCS) in patients suffering from chronic pain syndromes following spinal surgery has been published in the last decade. Evidence is scarce, however, for the use of high frequency SCS (HF-SCS) in the treatment of surgery naïve patients suffering from lower back pain (LBP).
  
  
  METHODS
  From June 2014 to April 2015, we prospectively enrolled patients suffering from LBP alone or in conjunction with leg pain in a trial of HF-SCS. None of the patients had undergone surgical procedures of the lumbar spine. Patients suffered medically intractable LBP and were deemed ineligible for spine surgery. All patients underwent trial stimulation for at least one week. Pain levels were assessed daily during initial stay, 4 weeks later and then every 3 months. Different preprogrammed modes of HF-SCS were changed if pain persisted or increased during trial or postimplant follow-up (FU).
  
  
  RESULTS
  Eight patients (four male, four female) underwent HF-SCS trials. Mean age was 60 ± 4.8 years. Mean numeric rating scale (NRS) baseline intensity for back pain was 8.9 ± 0.23 and 8.1 ± 0.6 for leg pain. All patients achieved meaningful reductions in pain intensities and underwent IPG implantation at a mean interval of 13 days. Mean follow-up was 306 days. Mean back pain reduction from baseline at last follow-up was -4.13 ± 0.85, and -6.2 ± 1.03 for leg pain. Two patients showed skin irritations and localized pain at the IPG site. Both patients underwent surgery to replant the IPG. No infections were seen in any of the eight patients enrolled.
  
  
  CONCLUSIONS
  In this prospective cohort of surgery naïve patients, we were able to show good efficacy of HF-SCS with mean NRS reductions of 4.13 and 6.2 for back and leg pain, respectively, after a mean follow-up of 10 months.
authors.affiliation: Department of Neurosurgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
authors.forename: Sebastian A
authors.initials: SA
authors.lastname: Ahmadi
authors.affiliation: Department of Neurosurgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.|Department of Functional Neurosurgery and Stereotaxy, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Vesper
authors.affiliation: Department of Neurosurgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.|Department of Neurosurgery, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schu
authors.affiliation: Department of Neurosurgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Slotty
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062187:Spinal Cord Stimulation / Q000379:methods* / Q000639:trends
keywords: High-frequency; spinal cord stimulation; surgery-naïve