Burst Stimulation: An Innovative Waveform Strategy for Spinal Cord Stimulation

Abstract

Since the advent of spinal cord stimulation (SCS) or traditional spinal cord stimulation (tSCS) by Norman Shealy in 1967, the evolution of dorsal column stimulation has continued, primarily focused on lead innovations. Disadvantages to current spinal cord stimulation strategies are inherent to how it works: it requires perceived congruent therapeutic paresthesia overlying the typical painful area. Challenges include the ability to place the paresthesia in congruent areas, the positionality associated with the required perception, and the need for the patient to consider the paresthesia therapeutic. New innovations in waveform strategies are moving away from the need to create a perceived paresthesia to achieve analgesia. This chapter explores one known as Burst Stimulation (Burst-SCS). It is important to appreciate that Burst-SCS was under investigation in the United States and required an Investigational Device Exemption (IDE). Because of the success of the trial, it was deemed superior to tSCS for back and leg pain treatment and is now FDA approved and available for use in the United States.