Cervical Spinal Cord Stimulation Using Monophasic Burst Waveform for Axial Neck and Upper Extremity Radicular Pain: A Preliminary Observational Study

Background: Cervical spinal cord stimulation (cSCS) is an accepted therapeutic option for radicular upper extremity pain and less commonly for cervical axial pain despite less available literature in comparison with lumbar and lower extremity applications. Methods: This preliminary observational pilot study evaluated the efficacy of cSCS using the monophasic burst pattern in the treatment of both upper extremity radicular pain and axial neck pain. Primary outcome measures were reduction in pain scores, global pain scale (GPS) indices, and neck Oswestry disability index (nODI). Results: Of the 23 subjects trialed, 15 went to implantation of cSCS using burst and were followed for 1 year prospectively. Pre- and postprimary outcome measures suggested a statistically (p < 0.05) and clinically significant 12.40 point differential in the nODI, a statistically significant reduction of the GPS from 74.60 to 56.37 (p < 0.05), and a reduction in the pain rating score from 8.13 +/− 1.0 prior to trial to 3.85 +/− 1.1 at 1 year for axial neck and with and without radicular pain (p < 0.05). Conclusions: This preliminary study suggests that the use of the burst waveform applied to cSCS results in improved function and decreased pain scores in subjects with axial neck pain with and without radicular symptomatology and cervicogenic headache. © 2019 International Neuromodulation Society