![]() Undergoing multiple revision surgeries is known to increase the risk of infection, particularly among patients with other risk factors such as uncontrolled diabetes mellitus, 15 and studies examining the effect of different IPGs on outcomes have found RC devices are indeed associated with lower rates of complications than NRC devices. 9–14 A longer lifespan for RC devices results in fewer surgeries, such as those to replace depleted IPGs. Published estimates of the comparative costs of NRC versus RC devices delivering conventional, low-frequency SCS for chronic pain have predominantly found the longer lifespan of the RC devices makes them more cost-effective overall. Conventional SCS can be provided by NRC or RC devices, while 10 kHz SCS is only available as an RC device. 8 Recharging is done via an external charger placed next to the skin, thus patients are limited in their activities during recharging periods. In 2005, rechargeable (RC) IPGs were introduced, offering reduced risk by avoiding the requirement for additional surgery to replace a depleted IPG. Conventional, non-rechargeable (NRC) IPGs must be replaced periodically with a new device via surgery once its power reserve is depleted. 7 SCS devices are powered by implantable pulse generators (IPGs) that generate the current delivered by the leads. ![]() 6 High-frequency SCS, delivered at 10 kilohertz (10 kHz SCS), is an alternative form of SCS that functions in a paresthesia-free manner and has been shown to provide superior pain relief for low back and lower limb pain. 5 Conventional SCS involves programming frequencies of less than 1000 Hz, most commonly in the 40–60 Hz range, and produces the sensation of paresthesia, which must overlap the area of pain to provide analgesia however, paresthesia can also cause discomfort that limits its use in some patients. 2–4 Spinal cord stimulation (SCS) has been used clinically since the 1980s, and has been proven to provide long-term, non-pharmacologic pain relief for chronic intractable pain from a variety of etiologies. 1 Pain is frequently treated with medications, including opioid analgesics, but such treatment has not been proven effective for long-term pain relief. Chronic pain is a common clinical condition, which has been estimated to affect over 20% of the adult population in the United States, with 8% suffering with chronic pain that substantially impacts their quality of life, such as limiting daily or work activities.
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