PROCO study - 1kHz as good as 10kHz

[gdub25]

https://neuronewsinternational.com/...1khz-10khz-spinal-cord-stimulation-proco-rct/


Anyone else see this? Just wondering thoughts. I haven't gotten the actual article yet, wondering if there's anything to it. Kapural out of Wake Forrest presented at NANS 100 patients that they put on 1kHz and followed for a year and showed it didn't work any better than traditional stim.

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[unchockey21]

https://neuronewsinternational.com/...1khz-10khz-spinal-cord-stimulation-proco-rct/


Anyone else see this? Just wondering thoughts. I haven't gotten the actual article yet, wondering if there's anything to it. Kapural out of Wake Forrest presented at NANS 100 patients that they put on 1kHz and followed for a year and showed it didn't work any better than traditional stim.

Saw the data after INS. Not impressed. There isn't an actual article yet as far as I know. One of the little joys of fellowship was to watch the Boston reps try to debate Kap on this stuff.

 

[Tapspatellas]

Study looks like it was well done. Point was not to show superiority or inferiority of stimulation frequency, was to compare different rates and see what patients would respond to, different designs. Eventually one can assume this will be done. PROCO Hasn't been published yet.

 

[BobBarker]

I believe the kapural study used 1000hz after traditional stim had failed and the leads were not moved. But haven't looked at it since it came out.

 

[nvrsumr]

what does "optimal neural dosing" mean in real terms?

 

[Tapspatellas]

what does "optimal neural dosing" mean in real terms?

Figuring out current, pulse width and frequency that obtains the best response without using unecessarily high parameters of any.

 

[nvrsumr]

neural dosing- sounds like the bs my medtronic rep says to confuse everyone on the superiority designation fda gave nevro.

 

[deleted472101]

This is trying to confirm what is better targetted level and or neural dosing (energy delivered). Boston is trying to tout this but it is what everyone can do. It is too preliminary to take it and use in clinical settings.

 

[Orin]

In practice, I do a paresthesia free stim at T9/10 or C2/3 first, and paresthesia after.

Trying to convince someone that paresthesia free is working after they've had paresthesia is difficult.

It's a shame Nevro didn't do a real study comparing on vs off to show that SCS actually works