Spinal cord stimulation
Nevro / Globus Medical
Nevro built its platform around 10 kHz high-frequency stimulation — a waveform delivered well above the frequency at which patients feel tingling, and therefore paresthesia-free by design. Nevro became a wholly owned subsidiary of Globus Medical when the acquisition closed on April 3, 2025.
At a glance
- Signature waveform
- 10 kHz high-frequency
- Paresthesia
- None by design
- Notable indications
- PDN and non-surgical refractory back pain
- Corporate
- Globus Medical subsidiary since April 3, 2025
10 kHz paresthesia-free stimulation, with indications in diabetic neuropathy and non-surgical back pain.
The Signature Technology
10 kHz therapy and HFX iQ
Conventional tonic stimulation runs in the tens to low hundreds of hertz and produces a tingling sensation that replaces the pain. 10 kHz therapy runs far above that range, and is designed to relieve pain without any stimulation sensation at all — which also means it does not need to be 'mapped' to the pain area in the same way. HFX iQ layers a programming algorithm on top of this, drawing on a very large dataset of prior implanted patients to suggest program adjustments based on how a given patient reports doing over time.
How It Works
From lead placement to therapy delivery
- 01
Leads are placed in the epidural space at anatomic landmarks rather than being positioned by paresthesia mapping, since the therapy produces no stimulation sensation.
- 02
The generator delivers 10 kHz stimulation continuously at settings selected by the physician.
- 03
With HFX iQ, patient-reported pain and function are fed back into a programming algorithm trained on a large historical dataset, which then recommends adjustments.
The Platforms
2 systems in the family
Each system in this family is built on the same underlying technology, but they differ in power source, size and intended use.
Senza / HFX
10 kHz SCS
The core 10 kHz spinal cord stimulation platform, marketed as HFX therapy along with its patient support program.
- Paresthesia-free by design
- Rechargeable generator
- HFX Cloud remote programming support
HFX iQ
Algorithm-guided 10 kHz SCS
The current generation, adding an algorithm trained on a large dataset of previously implanted patients to guide program selection.
- Algorithm-guided programming
- Trained on data from tens of thousands of implanted patients
- Ongoing patient-reported outcome tracking
The Evidence
What has been published
Each study is given with its design, who was actually in it, what it found and where it falls short — then a link to the paper itself, so you can check any of it. Most device trials are manufacturer-funded; that is normal in this field and it is labelled here rather than glossed over.
SENZA-RCT
The pivotal randomized controlled trial comparing 10 kHz therapy against traditional low-frequency SCS in chronic back and leg pain, which supported the original approval.
SENZA-PDN
The randomized controlled trial in painful diabetic neuropathy that supported the PDN indication — an important expansion beyond post-surgical back and leg pain.
SENZA-NSRBP
The randomized controlled trial in non-surgical refractory back pain, addressing patients who have never had spine surgery and are not surgical candidates.
These are the studies specific to Nevro. For the trials that shaped the whole field — and for how to read an industry-sponsored study fairly — see the clinical evidence library.
The Trade-offs
What to weigh before choosing this platform
No system is the right answer for every patient. These are considerations to discuss with the clinician who knows your history.
A paresthesia-free therapy cannot be titrated by feel, which changes how trials are assessed and how programming decisions are made.
The PDN indication has made 10 kHz relevant to a patient population quite different from the classic post-laminectomy patient.
Higher-frequency stimulation has energy implications; charging expectations should be discussed before implant.
Regulatory status
Senza is FDA approved for chronic intractable pain of the trunk and/or limbs, with subsequent indications including painful diabetic neuropathy and non-surgical refractory back pain.
Indications, contraindications, warnings and MRI conditions are defined by the current labeling. Review the manufacturer's Instructions for Use at nevro.com and discuss them with your physician.
Wondering whether this therapy fits your situation?
Explore how candidacy is assessed, then discuss your pain pattern, imaging and prior treatments with a clinician. Device selection comes later.