Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Prospective, Randomized Study Comparing Conventional, Burst And High Frequency (HF) Spinal Cord Stimulation (SCS) in Refractory Failed Back Surgery Syndrome (FBSS) Patients After a 32-contact Surgical Lead Implantation
Brief Summary: Chronic Back and/or Leg Pain (CBLP) after spinal surgical procedures, a condition commonly labelled Failed Back Surgery Syndrome (FBSS), affects between 15% and 40% of patients after a spine surgery. Treatment of this chronic condition by further operation or medical management has a heavy financial impact on health care systems.

Many studies have demonstrated the efficacy and economic value of Spinal Cord Stimulation (SCS) for chronic neuropathic pain, and randomized controlled trials (RCTs) have shown SCS to be a clinically effective adjunct to medical management. SCS has the advantages of being reversible and less invasive than surgery and may cause fewer issues over time than long-term pharmacological treatments.

Despite variable levels of success in the literature, approximately 30-55% of the patients treated with traditional SCS for neuropathic pain disorders will not receive adequate long term pain relief. Therefore, technical SCS system refinements, as well as new techniques have emerged.

Two new stimulation waveforms based on traditional SCS technology have appeared to further optimize the outcome for specific painful conditions;

* Burst stimulation mode: which generates constant-current stimuli with 5 spikes at 500 Hz per burst and pulse width and interspike intervals of 1 ms.
* High-frequency stimulation (from 1 to 10 kHz) mode.

Several studies have demonstrated the potential interest of these 2 new waveforms to treat FBSS patients compared to traditional SCS.

The Precision Spectra™ system allows MultiWave Technology by offering a broad spectrum of waveform options (from Tonic Conventional Stimulation (TCS), BURST stimulation to High Frequency stimulation (HF)).

To date, literature data comparing these 3 stimulation patterns is lacking but it is suggested the pain relief in some of non-responsive patients can be "recaptured" by increasing the SCS frequency to 500 Hz by BURST stimulation or beyond by HF stimulation. It seems important to conduct RCT in crossover, thanks to the new Precision SCS Stimulator, to compare the effects of these 3 different SCS modalities in FBSS patients and to determine which concept is the most effective in terms of pain reduction and energy consumption.


Options:
A: Arm Label: Study sequence A; Type: EXPERIMENTAL; Interventions: Device: Proclaim™ Elite 5: Burst - Washout - Sham | Arm Label: Study sequence B; Type: EXPERIMENTAL; Interventions: Device: Proclaim™ Elite 5: Sham - Washout - Burst | Intervention Type: DEVICE; Name: Proclaim™ Elite 5: Burst - Washout - Sham; Assigned to Arm(s): Study sequence A | Intervention Type: DEVICE; Name: Proclaim™ Elite 5: Sham - Washout - Burst; Assigned to Arm(s): Study sequence B
B: Arm Label: HF/TCS/BURST; Type: EXPERIMENTAL; Interventions: Device: Precision Spectra™ system | Arm Label: HF/BURST/TCS; Type: EXPERIMENTAL; Interventions: Device: Precision Spectra™ system | Arm Label: BURST/HF/TCS; Type: EXPERIMENTAL; Interventions: Device: Precision Spectra™ system | Arm Label: BURST/TCS/HF; Type: EXPERIMENTAL; Interventions: Device: Precision Spectra™ system | Arm Label: TCS/BURST/HF; Type: EXPERIMENTAL; Interventions: Device: Precision Spectra™ system | Arm Label: TCS/HF/BURST; Type: EXPERIMENTAL; Interventions: Device: Precision Spectra™ system | Intervention Type: DEVICE; Name: Precision Spectra™ system; Assigned to Arm(s): BURST/HF/TCS, BURST/TCS/HF, HF/BURST/TCS, HF/TCS/BURST, TCS/BURST/HF, TCS/HF/BURST
C: Arm Label: Monocolumn spinal cord stimulation; Type: ACTIVE_COMPARATOR; Interventions: Device: comparison of spinal cord stimulation | Arm Label: Multicolumn spinal cord stimulation; Type: EXPERIMENTAL; Interventions: Device: comparison of spinal cord stimulation | Intervention Type: DEVICE; Name: comparison of spinal cord stimulation; Assigned to Arm(s): Monocolumn spinal cord stimulation, Multicolumn spinal cord stimulation
D: Arm Label: CMM; Type: OTHER; Interventions: Other: CMM | Arm Label: HF10 + CMM; Type: ACTIVE_COMPARATOR; Interventions: Device: HF10 Therapy, Other: CMM | Intervention Type: DEVICE; Name: HF10 Therapy; Assigned to Arm(s): HF10 + CMM | Intervention Type: OTHER; Name: CMM; Assigned to Arm(s): CMM, HF10 + CMM

Answer: B