Background: Chronic pain is frequently treated with opioid analgesics, but there is limited evidence for efficacy for chronic use of opioids and the drugs pose significant risks to patients' physical and mental health. Spinal cord stimulation delivered at a frequency of 10,000 Hertz (10 kHz SCS) is a minimally invasive therapy with demonstrated efficacy and safety in treating chronic pain that has also been associated with decreased opioid use.
Objective: To evaluate opioid reduction and pain relief in real-world cohort.
Study design: Retrospective review.
Setting: Single center.
Patients and methods: Consecutive patients who were implanted with 10 kHz SCS devices from December 1, 2015, to June 30, 2020 for the treatment of chronic pain in the trunk or lower limbs were included. Changes in opioid use following 10 kHz SCS treatment were extracted from electronic medical records, and patient-reported pain relief, improvement in function and sleep were extracted from manufacturer's database. Responder rate was defined as the proportion of patients with at least 50% pain relief. Anonymised results from descriptive analysis of the data are reported.
Results: At last follow-up (median 21.4 months), mean daily opioid dose fell by 48.4 morphine milligram equivalents (MME), and fewer patients used opioids. Mean pain relief in these patients was 57% ± 4%, and responder rate was 68% at last recorded follow-up. Interestingly, pain relief (66%) and responder rate (86%) were higher in patients with 1 year or more. Finally, 50% of patients reported improved sleep, and 73% reported improvement in function at last recorded follow-up after treatment with 10 kHz SCS.
Conclusion: These results support 10 kHz SCS as a safe and effective treatment of chronic pain in real-world patients with secondary benefits to opioid consumption and measures of patients' quality of life.
Keywords: chronic pain; failed back surgery syndrome; opioid analgesics; spinal cord stimulation.
© 2021 Feng et al.