The burst spinal cord stimulation for chronic back and limb pain
Inspite of increasing paresthesia and alleviating pain poorly to a little extent, the traditional tonic spinal cord stimulation (SCS) has been approved by FDA for chronic pain of intractable back and limb pain. Currently, burst SCS has been made for pain reduction without the obligatory paresthesia.
A study was conducted which was a systematic review of the burst SCS for chronic back and limb pain with an intension to ascertain the effects of burst SCS on pain relief without paresthesia for various conditions like failed back surgery syndrome, painful diabetic neuropathy and radiculopathy.
This was done with the help of the accessible literature on burst SCS in managing chronic pain without paresthesia was reviewed. For grading the evidence and risk of bias, 2011 American Academy of Neurology (AAN) Classification of Evidence Guidelines Process Manual was used. Through the efficient searches of PubMed, MEDLINE/OVID, SCOPUS, the data was collected and the manual searches included the bibliographies of known primary and review articles. Pain relief and paresthesia status was the primary outcome measure and secondary measures involved improvements in pain quality, functional status and complications. Five studies consisting of a total of 117 patients met the eligibility criteria and were graded as Class IV study. The overall paucity of high quality studies was considered as a restriction of this systematic review.
The inference of this study provided that the burst SCS is a novel approach that possibly leads to more pain reduction for short duration than tonic SCS without eliciting paresthesia. For treating chronic intractable pain, the evidence based on this systematic review is considered fair and limited. This is an AAN recommendation level U. Future research is required with a larger sample size and a standardized study design.