• Terje Kirketeig, Carsten Schultheis, Xander Zuidema, Corey W Hunter, and Timothy Deer.
• Multidisciplinary Pain Clinic, Uppsala University Hospital, Uppsala, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
• Pain Med. 2019 Jun 1; 20 (Suppl 1): S31-S40.

ObjectiveClinical review on outcomes using burst spinal cord stimulation (SCS) in the treatment of chronic, intractable pain.DesignNarrative clinical literature review conducted utilizing a priori search terms including key words for burst spinal cord stimulation. Synthesis and reporting of data from publications including an overview of comparative SCS outcomes.ResultsBurst SCS demonstrated greater pain relief over tonic stimulation in multiple studies, which included blinded, sham-controlled, randomized trials. Additionally, burst stimulation impacts multiple dimensions of pain, including somatic pain as well as emotional and psychological elements. Patient preference is weighted toward burst over tonic due to increased pain relief, a lack of paresthesias, and impression of change in condition.ConclusionBurst SCS has been shown to be both statistically and clinically superior to tonic stimulation and may provide additional benefits through different mechanisms of action. Further high-quality controlled studies are warranted to not only elucidate the basic mechanisms of burst SCS but also address how this unique stimulation signature/pattern may more adequately handle the multiple affective dimensions of pain in varying patient populations.© 2019 American Academy of Pain Medicine.

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