Successful application of burst spinal cord stimulation for refractory upper limb pain: a case series

Journal of International Medical Research, 2021 · DOI: 10.1177/03000605211004035 · Published: March 1, 2021

Simple Explanation

Spinal cord stimulation (SCS) is used for pain that doesn't respond to other treatments. Burst waveform SCS, a newer type, might work better for certain difficult-to-treat pain conditions. This case report presents two patients with upper limb pain after spinal cord injury and amputation. Burst waveform SCS helped reduce their pain when conventional SCS didn't. Further research is needed to fully understand how burst waveform SCS works and how well it can treat persistent pain.

Study Duration

Not specified

Participants

2 patients with refractory upper limb pain

Evidence Level

Level 4: Case Series

Key Findings

1
Conventional tonic waveform SCS was not very effective for pain reduction in either patient with refractory upper limb pain.
2
Burst waveform SCS decreased pain intensity by more than 50% in both patients.
3
Patients reported paresthesia with conventional tonic waveforms but not with burst waveforms.

Research Summary

This case report describes successful outcomes in two patients with refractory upper limb pain after spinal cord injury and upper limb amputation using burst waveform SCS. Conventional tonic waveform SCS was initially applied to treat refractory upper limb pain. However, it was not very effective for pain reduction in either patient. In conclusion, this current case report has described the successful management of two cases of refractory upper limb pain after spinal cord injury and limb amputation using burst waveform SCS.

Practical Implications

Potential Alternative for Intractable Pain

Burst waveform SCS may be a viable alternative for patients with intractable upper limb pain who do not respond well to conventional tonic waveform SCS.

Improved Patient Comfort

The absence of paresthesia with burst waveform SCS may improve patient comfort and compliance, leading to better pain management outcomes.

Further Research Needed

Larger, controlled studies are needed to confirm the efficacy and mechanisms of burst waveform SCS in specific pain conditions.

Study Limitations

1
Small sample size (two cases).
2
Retrospective design.
3
Conventional tonic waveform SCS was not applied for a sufficient time in both patients.

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