ArticleRegional anesthesia and pain medicine2022
Stimulation holiday rescues analgesia after habituation and loss of efficacy from 10-kilohertz dorsal column spinal cord stimulation.
Article in Regional anesthesia and pain medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Mortality Outcomes After Spinal Cord Stimulation: A 10-Year Survival Analysis of 330 Patients With Chronic Neuropathic Pain.Neurosurgery · 2026Article
- A Quasi-Resonant System for High-Frequency Trans-Spinal Magnetic Stimulation (HF-TSMS).IEEE transactions on bio-medical engineering · 2025Article
- Automated Neural Dosing for Fast-Acting Subperception Therapy: Sustained Spinal Cord Stimulation Outcomes from a Multicenter Study.Pain and therapy · 2025Article
- Neuromodulation techniques for the treatment of spinal cord injury: current progress, challenges, and future prospects.European journal of medical research · 2025Review
- Device Evaluation, Treatment, and Explantation Recommendations (DETER): Review and Best Practices for Managing Neuromodulation Device Infections.Journal of pain research · 2025Article
- A Call for Reckoning and Reform in Interventional Pain Medicine and Neuromodulation Research.Journal of pain research · 2025Article
- Extreme pulse dosing of 10 kHz spinal cord stimulation: how low can you go?Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Neuromodulation and Habituation: A Literature Review and Conceptional Analysis of Sustaining Therapeutic Efficacy and Mitigating Habituation.Biomedicines · 2024Review
- Improved Outcomes and Therapy Longevity after Salvage Using a Novel Spinal Cord Stimulation System for Chronic Pain: Multicenter, Observational, European Case Series.Journal of clinical medicine · 2024Article
- Case Report: Rescue of Relapsed Pain in a Patient with Complex Regional Pain Syndrome Type II by Adding Another Dorsal Root Ganglion Lead.International medical case reports journal · 2024Article
- Pathophysiology of Pain and Mechanisms of Neuromodulation: A Narrative Review (A Neuron Project).Journal of pain research · 2024Review
- Biologic Complications Associated with Cylindrical Lead Spinal Cord Stimulator Implants: A Narrative Review.Orthopedic reviews · 2024Article
- Long term outcomes of occipital nerve stimulation.Frontiers in pain research (Lausanne, Switzerland) · 2023Review
- Implantable Peripheral Nerve Stimulation for Peripheral Neuropathic Pain: A Systematic Review of Prospective Studies.Biomedicines · 2022Review
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionHabituation and loss of efficacy from spinal cord stimulation are commonly reported. This retrospective analysis investigated rescue of analgesia from spinal cord stimulation failure after implementing a strategy called a stimulation holiday, during which spinal cord stimulation is interrupted for a defined period and subsequently restarted.
methodsA 6-year review (June 1, 2016-May 13, 2022) from a tertiary care center was conducted on patients who underwent 10 kHz frequency dorsal column spinal cord stimulation for ≥3 months, experienced loss of efficacy (≤30% pain relief or patient self-report of lack of meaningful pain relief), subsequently underwent a stimulation holiday, and then restarted spinal cord stimulation. The primary outcome was comparison of pain relief and responder rate (≥50% relief in pain intensity) before and after stimulation holiday.
resultsOf 212 patients, 40 (18.9%) experienced loss of efficacy at a mean follow-up period of 452.7±326.4 days after stimulator implantation and underwent stimulation holiday. Pain relief was significantly higher 1 month after stimulation holiday (39.4%±28.6%) compared with before stimulation holiday (8.7%±13.0%; mean difference 30.6%, 95% CI 21.9% to 39.3%, paired t-test p<0.001). A significantly higher responder rate (≥50% relief in pain intensity) was identified after stimulation holiday (57.5%) compared with before stimulation holiday (0%; Fisher's exact test p<0.001). Associations of superior pain relief and responder rate remained significant at 3 and 6 months after stimulation holiday. DISCUSSION: Patients who experience loss of efficacy from spinal cord stimulation habituation could attempt a stimulation holiday rather than abandon therapy. Rescue of analgesia may be achieved after implementing a stimulation holiday and restarting spinal cord stimulation.
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