Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9.

CAS  PubMed  Google Scholar 

Hillman P, Wall PD. Inhibitory and excitatory factors influencing the receptive fields of lamina 5 spinal cord cells. Exp Brain Res. 1969;9(4):284–306.

CAS  PubMed  Google Scholar 

Kapural L, Yu C, Doust MW, Gliner BE, Vallejo R, Sitzman BT, et al. Novel 10-kHz high-frequency therapy (HF10 therapy) is superior to traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: the SENZA-RCT randomized controlled trial. Anesthesiology. 2015;123(4):851–60.

PubMed  Google Scholar 

Deer T, Slavin KV, Amirdelfan K, North RB, Burton AW, Yearwood TL, et al. Success using neuromodulation with BURST (SUNBURST) study: results from a prospective, randomized controlled trial using a novel burst waveform. Neuromodulation. 2018;21(1):56–66.

PubMed  Google Scholar 

Deer TR, Patterson DG, Baksh J, Pope JE, Mehta P, Raza A, et al. Novel intermittent dosing burst paradigm in spinal cord stimulation. Neuromodulation. 2021;24(3):566–73.

PubMed  Google Scholar 

Vesper J, Slotty P, Schu S, Poeggel-Kraemer K, Littges H, Van Looy P, et al. Burst SCS microdosing is as efficacious as standard burst SCS in treating chronic back and leg pain: results from a randomized controlled trial. Neuromodulation. 2019;22(2):190–3.

PubMed  Google Scholar 

Leong SL, De Ridder D, Deer T, Vanneste S. Potential therapeutic effect of low amplitude burst spinal cord stimulation on pain. Neuromodulation. 2021;24(3):574–80.

PubMed  Google Scholar 

Provenzano D, Tate J, Gupta M, Yu C, Verrills P, Guirguis M, et al. Pulse dosing of 10-kHz paresthesia-independent spinal cord stimulation provides the same efficacy with substantial reduction of device recharge time. Pain Med. 2022;23(1):152–63.

PubMed  Google Scholar 

Thomson SJ, Tavakkolizadeh M, Love-Jones S, Patel NK, Gu JW, Bains A, et al. Effects of rate on analgesia in kilohertz frequency spinal cord stimulation: results of the PROCO randomized controlled trial. Neuromodulation. 2018;21(1):67–76.

PubMed  Google Scholar 

Paz-Solís J, Thomson S, Jain R, Chen L, Huertas I, Doan Q. Exploration of high- and low-frequency options for subperception spinal cord stimulation using neural dosing parameter relationships: the HALO study. Neuromodulation. 2022;25(1):94–102.

PubMed  Google Scholar 

Sandkühler J. Models and mechanisms of hyperalgesia and allodynia. Physiol Rev. 2009;89(2):707–58.

PubMed  Google Scholar 

Lee KY, Ratté S, Prescott SA. Excitatory neurons are more disinhibited than inhibitory neurons by chloride dysregulation in the spinal dorsal horn. eLife. 2019;8.

Gilbert JE, Titus N, Zhang T, Esteller R, Grill WM. Surround inhibition mediates pain relief by low amplitude spinal cord stimulation: modeling and measurement. eNeuro. 2022;9(5): ENEURO.0058-22.2022.

PubMed  PubMed Central  Google Scholar 

Heijmans L, Zhang TC, Esteller R, Joosten EA. Ninety-Hz spinal cord stimulation-induced analgesia is dependent on active charge balance and is nonlinearly related to amplitude: a sham-controlled behavioral study in a rodent model of chronic neuropathic pain. Neuromodulation. 2024;27(1):95–107.

PubMed  Google Scholar 

Metzger CS, Hammond MB, Paz-Solis JF, Newton WJ, Thomson SJ, Pei Y, et al. A novel fast-acting sub-perception spinal cord stimulation therapy enables rapid onset of analgesia in patients with chronic pain. Expert Rev Med Devices. 2021;18(3):299–306.

CAS  PubMed  Google Scholar 

Anitescu M et al. Prospective, multicenter outcomes utilizing an SCS-system designed to engage surround inhibition using fast-acting sub-perception therapy [Abstract #75]. ASPN, session; Miami Beach, FL, USA; 2024.

Bayerl S, Paz-Solis J, Matis G, Rigoard P, Kallewaard JW, Canos-Verdecho MA, et al. Long-term outcomes using novel, fast-acting, sub-perception spinal cord stimulation therapy for chronic pain: a European, observational. Real-World Study J Clin Med. 2024;13:6999.

CAS  Google Scholar 

Metzger C, Hammond B, Ferro R, North J, Pyles S, Kranenburg A, et al. Two-year outcomes using fast-acting sub-perception therapy for spinal cord stimulation: results of a real-world multicenter study in the United States. Expert Rev Med Devices. 2025;22(2):155–64.

CAS  PubMed  Google Scholar 

Chakravarthy K, Reddy R, Al-Kaisy A, Yearwood T, Grider J. A call to action toward optimizing the electrical dose received by neural targets in spinal cord stimulation therapy for neuropathic pain. J Pain Res. 2021;14:2767–76.

PubMed  PubMed Central  Google Scholar 

Kumar K, Hunter G, Demeria D. Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery. 2006;58(3):481–96.

PubMed  Google Scholar 

Deer TR, Mekhail N, Provenzano D, Pope J, Krames E, Thomson S, et al. The appropriate use of neurostimulation: avoidance and treatment of complications of neurostimulation therapies for the treatment of chronic pain. Neuromodulation Appropriateness Consensus Committee. Neuromodulation. 2014;17(6):571–97 (discussion 97-8).

PubMed  Google Scholar 

Aiudi CM, Dunn RY, Burns SM, Roth SA, Opalacz A, Zhang Y, et al. Loss of efficacy to spinal cord stimulator therapy: clinical evidence and possible causes. Pain Physician. 2017;20(7):E1073–80.

PubMed  Google Scholar 

Hayek SM, Veizi E, Hanes M. Treatment-limiting complications of percutaneous spinal cord stimulator implants: a review of eight years of experience from an academic center database. Neuromodulation. 2015;18(7):603–8 (discussion 8-9).

PubMed  Google Scholar 

Hunter CW, Carlson J, Yang A, Patterson D, Lowry B, Mehta P, et al. BURST(able): a retrospective, multicenter study examining the impact of spinal cord stimulation with burst on pain and opioid consumption in the setting of salvage treatment and “upgrade.” Pain Physician. 2020;23(6):E643–58.

PubMed  Google Scholar 

Van Buyten JP, Wille F, Smet I, Wensing C, Breel J, Karst E, et al. Therapy-related explants after spinal cord stimulation: results of an international retrospective chart review study. Neuromodulation. 2017;20(7):642–9.

PubMed  PubMed Central  Google Scholar 

Pope JE, Deer TR, Falowski S, Provenzano D, Hanes M, Hayek SM, et al. Multicenter retrospective study of neurostimulation with exit of therapy by explant. Neuromodulation. 2017;20(6):543–52.

PubMed  Google Scholar 

Patil AS, Levasseur B, Gupta M. Neuromodulation and habituation: a literature review and conceptional analysis of sustaining therapeutic efficacy and mitigating habituation. Biomedicines. 2024;12(5):930.

CAS  PubMed  PubMed Central  Google Scholar 

Hagedorn JM, Layno-Moses A, Sanders DT, Pak DJ, Bailey-Classen A, Sowder T. Overview of HF10 spinal cord stimulation for the treatment of chronic pain and an introduction to the Senza Omnia™ system. Pain Manag. 2020;10(6):367–76.

PubMed  Google Scholar 

Lo Bianco G, Al-Kaisy A, Natoli S, Abd-Elsayed A, Matis G, Papa A, et al. Neuromodulation in chronic pain management: addressing persistent doubts in spinal cord stimulation. J Anesth Analg Crit Care. 2025;5(1):3.

PubMed  PubMed Central  Google Scholar 

D'Souza RS, Her YF. Stimulation holiday rescues analgesia after habituation and loss of efficacy from 10-kilohertz dorsal column spinal cord stimulation. Reg Anesth Pain Med. 2022;47(12):722–27.

PubMed  PubMed Central  Google Scholar 

North J, Loudermilk E, Lee A, Sachdeva H, Kaiafas D, Washabaugh E, et al. Outcomes of a multicenter, prospective, crossover, randomized controlled trial evaluating subperception spinal cord stimulation at ≤1.2 kHz in previously implanted subjects. Neuromodulation. 2020;23(1):102–8.

PubMed  Google Scholar 

Andrade P, Heiden P, Visser-Vandewalle V, Matis G. 1.2 kHz high-frequency stimulation as a rescue therapy in patients with chronic pain refractory to conventional spinal cord stimulation. Neuromodulation. 2021;24(3):540–5.

PubMed  Google Scholar 

Rigoard P, Billot M, Bougeard R, Llopis JE, Raoul S, Matis G, et al. Improved outcomes and therapy longevity after salvage using a novel spinal cord stimulation system for chronic pain: multicenter, observational, European case series. J Clin Med. 2024;13(4):1079.

PubMed  PubMed Central  Google Scholar 

Rigoard P, Ounajim A, Goudman L, Banor T, Héroux F, Roulaud M, et al. The challenge of converting “failed spinal cord stimulation syndrome” back to clinical success, using SCS reprogramming as salvage therapy, through neurostimulation adapters combined with 3D-computerized pain mapping assessment: a real life retrospective study. J Clin Med. 2022;11(1):272.

PubMed  PubMed Central  Google Scholar 

Reddy RD, Moheimani R, Yu GG, Chakravarthy KV. A review of clinical data on salvage therapy in spinal cord stimulation. Neuromodulation. 2020;23(5):562–71.

PubMed  Google Scholar 

D’Souza RS, ElSaban M, Martinez Alvarez GA, Jin MY, Kubrova E, Hassett LC. Treatment of pain in length-dependent peripheral neuropathy with the use of spinal cord stimulation: a systematic review. Pain Med. 2023;24(Supplement_2):S24-s32.

PubMed  Google Scholar 

Mekhail NA, Levy RM, Deer TR, Kapural L, Li S, Amirdelfan K, et al. ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial. Reg Anesth Pain Med. 2024;49(5):346–54.

PubMed  Google Scholar 

Nijhuis H, Kallewaard JW, van de Minkelis J, Hofsté WJ, Elzinga L, Armstrong P, et al. Durability of evoked compound action potential (ECAP)-controlled, closed-loop spinal cord stimulation (SCS) in a real-world European chronic pain population. Pain Ther. 2024;13(5):1119–36.

PubMed  PubMed Central  Google Scholar 

Pilitsis JG, Chakravarthy KV, Will AJ, Trutnau KC, Hageman KN, Dinsmoor DA, et al. The evoked compound action potential as a predictor for perception in chronic pain patients: tools for automatic spinal cord stimulator programming and control. Front Neurosci. 2021;15: 673998.

PubMed  PubMed Central  Google Scholar 

Loudermilk E, Haddock A, Allavatam V, Shivacharan R, Esteller R. Analysis of ECAP detection levels and paresthesia-free spinal cord stimulation dose. north american neuromodulation society annual meeting, session "universal principles of the SCS therapeutic window: from mechanisms to clinical practice"; Orlando, FL, USA; Jan 31, 2025.

Mangano N, Torpey A, Devitt C, Wen GA, Doh C, Gupta A. Closed-loop spinal cord stimulation in chronic pain management: mechanisms, clinical evidence, and emerging perspectives. Biomedicines. 2025;13(5):1091.

PubMed  PubMed Central  Google Scho