Using Lower Amplitudes to Maintain Effective High Dose Spinal Cord Stimulation Therapy (SCS Dosing Pilot Study)

Area of Science:

• Neurosurgery
• Pain Management
• Neuromodulation

Background:

• Spinal cord stimulation (SCS) is a proven therapy for chronic pain.
• Limited data exists on minimum amplitude requirements for high-dose SCS parameters.
• This study addresses the need for guidance on amplitude settings for high-dose SCS.

Purpose of the Study:

• To determine the minimum amplitude required to maintain patient satisfaction and pain relief during high-dose SCS.
• To investigate amplitude dose-response in patients treated with 1000 Hz and 90 μsec SCS parameters.

Main Methods:

• Patients with chronic pain receiving high-dose SCS (1000 Hz, 90 μsec) were enrolled.
• Participants underwent blinded amplitude titration at 80%, 60%, 40%, and 20% of their baseline perception threshold.
• Patient satisfaction and pain scores (VAS) were assessed at each amplitude level.

Main Results:

• The majority of patients maintained therapy satisfaction (70%) and pain relief (63.3%) at 20% perception threshold amplitude.
• A significant portion of patients required lower amplitudes than initially expected for effective pain management.
• Five patients needed their original baseline amplitude to sustain therapy effectiveness.

Conclusions:

• High-dose SCS can be effective at amplitudes significantly below the perception threshold in a majority of patients.
• These findings suggest potential for optimizing SCS therapy by reducing amplitude while maintaining efficacy.
• Further research can explore the long-term effects and patient variability in response to low-amplitude high-dose SCS.