Background/aims
There is not sufficient evidence supporting the use of spinal cord stimulation (SCS) in spinal cord injury (SCI)1. Retrospective studies showed promising results in SCI patients treated with high-frequency SCS at 10 kHz (10 kHz SCS)2,3. This prospective, feasibility study aims to evaluate the safety and effectiveness of 10 kHz SCS for chronic neuropathic pain in SCI patients.
Methods
Subjects with chronic, neuropathic pain of ≥5 cm (visual analog scale, VAS) in the pain area directly related to SCI were enrolled. Subjects were trialed with 10 kHz SCS. Subjects with a successful trial (≥50% pain relief) were implanted with a Senza system (Nevro Corp., Redwood City, CA, USA). Safety and effectiveness endpoints were captured up to 12 months post-implant. 
Results
Twelve out of the 18 enrolled subjects underwent a trial implant; scar tissue precluded lead placement in 2 subjects and 6 out of the remaining 10 had a successful trial.
Baseline mean (±SD) pain scores of 9.0±0.9 cm (N=5) improved to 2.3±1.7 cm (N=5) at the end of trial. Pain scores remained improved at 3.1±1.6 cm (N=5), 4.8±4.0 cm (N=5), 5.1±3.3 cm (N=5), 1.7±0.6 cm (N=4) and 3.2±1.4 cm (N=3) at 1, 3, 6 and 12 month post-implant follow-up. Two subjects were reclassified from ASIA A at baseline to ASIA B at their 3, 6 and 12 month visits due to improved sensory function.
Conclusion
This study provides promising preliminary results using 10 kHz SCS in SCI patients to alleviate chronic pain with a potential benefit of improved sensory function. 


References
1.	Lagauche et al. Ann.Phy.Rehab.Med. 52 (2009) 180-187.
2.	Sisson et al.. Abstract & Poster, NANS congress 2018.
3.	Verdolin. Abstract & Poster, NANS congress 2018.

HIGH FREQUENCY SPINAL CORD STIMULATION AT 10 KHZ (10 KHZ SCS) FOR THE TREATMENT OF CHRONIC NEUROPATHIC PAIN RESULTING FROM SPINAL CORD INJURY