Introduction: High-frequency spinal cord stimulation (HFSCS) offers an alternative treatment for chronic refractory pain syndromes nonresponsive to traditional spinal cord stimulation (SCS). Following the conflicting findings of preliminary HFSCS clinical studies performed at 5-10 kHz, this study is the first to report successful clinical usage of 1-kHz frequency SCS with a standard generator. Patients: We used HFSCS in 2 patients who had inadequate relief with traditional SCS. Patient 1 was initially programmed at 40 Hz and a pulse width of 330 μs with bipolar stimulation. After multiple setting adjustments with inadequate pain relief, the patient was reprogrammed to HFSCS at settings of 1.15 kHz, 120 μs, and 5 V. Patient 2 was initially programmed at a frequency of 1.2 kHz and a pulse width of 120 μs, which she favored over the standard setting of 40 Hz and 390 μs pulse width. HFSCS provided optimal pain alleviation and increased quality of life for both patients. Conclusions: HFSCS at the frequency of 1 kHz offers a new tool for treatment of chronic pain in patients with traditional stimulation settings. Furthermore, most standard SCS batteries are capable of delivering stimulation in this frequency range.

1.
Zhang T, Janik J, Grill W: Mechanisms and models of spinal cord stimulation for the treatment of neuropathic pain. Brain Res 2014;1569:19-31.
2.
Smits H, van Kleef M, Holsheimer J, Joosten EA: Experimental spinal cord stimulation and neuropathic pain: mechanism of action, technical aspects, and effectiveness. Pain Pract 2013;13:154-168.
3.
Clark J: Spinal cord stimulation: does frequency matter? Anesthesiology 2013;119:243-244.
4.
Molnar G, Barolat G: Principles of cord activation during spinal cord stimulation. Neuromodulation 2014;17(suppl 1):12-21.
5.
Shechter R, Yang F, Xu Q, Cheong YK, He SQ, Sdrulla A, Guan Y: Conventional and kilohertz-frequency spinal cord stimulation produces intensity- and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain. Anesthesiology 2013;119:422-432.
6.
Van Buyten J, Al-Kaisy A, Smet I, Palmisani S, Smith T: High-frequency spinal cord stimulation for the treatment of chronic back pain patients: results of a prospective multicenter European clinical study. Neuromodulation 2013;16:59-66.
7.
Al-Kaisy A, Van Buyten J, Smet I, Palmissani S, Pang D, Smith T: Sustained effectiveness of 10 kHz high-frequency spinal cord stimulation for patients with chronic, low back pain: 24-month results of a prospective multicenter study. Pain Med 2014;15:347-354.
8.
Perruchoud C, Eldabe S, Batterham A, Madzinga G, Brookes M, Bovet N, Buchser E: Analgesic efficacy of high-frequency spinal cord stimulation: a randomized double-blind placebo-controlled study. Neuromodulation 2013;16:363-369.
9.
Stojanovic MP, Abdi S: Spinal cord stimulation. Pain Physician 2002;5:156-166.
10.
Deer TR, Mekhail N, Provenzano D, Pope J, Krames E, Leong M, North R: The appropriate use of neurostimulation of the spinal cord and peripheral nervous system for the treatment of chronic pain and ischemic diseases: the Neuromodulation Appropriateness Consensus Committee. Neuromodulation 2014;17:515-550.
11.
Slavin K: Spinal stimulation for pain: future applications. Neurotherapeutics 2014;11:535-542.
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