High-Frequency Spinal Cord Stimulation Background
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Nevro Corp. • 4040 Campbell Ave, Suite 210, Menlo Park, CA 94025 USA • 650-251-0005 High-Frequency Spinal Cord Stimulation Background High-Frequency Spinal Cord Stimulation (HF-SCS) Spinal cord stimulation (SCS) is an established pain treatment that delivers electrical pulses to the spinal cord to alter the transmission of abnormal pain signals to the brain. The electrical pulses are delivered by small electrodes that are placed near the spinal cord and connected to a compact battery-powered generator implanted under the skin. Traditional (low frequency) SCS typically attempts to mask the sensation of pain with a tingling or buzzing sensation, known as paresthesia. High-frequency SCS, pioneered by Nevro, aims to reduce the sensation of pain without inducing paresthesia, so that patients feel pain relief without feeling the The novel Nevro waveform features a stimulation frequency that is orders of magnitude higher than Clinical Results The Senza™ High-Frequency SCS System has been evaluated in numerous clinical studies involving hundreds of patients in the United States, Europe and Australia. Following early feasibility studies, Nevro sponsored a prospective, multicenter European clinical study to evaluate the safety and effectiveness of high-frequency spinal cord stimulation (HF-SCS) for the treatment of patients with chronic back and leg pain. Nevro EU Prospective Multicenter Study Highlights1 Design • 82 patients studied • Key inclusion criteria: back pain visual analog score (VAS) > 5 out of 10 • Key exclusion criteria: standard contraindications for SCS Key Results • Very high (88%) trial phase success rate (patients typically evaluate stimulation via a trial stimulator prior to deciding whether to get an • Significant 15-point improvement in Oswestry Disability Index (a measure of • Significant (40%) reduction in number of patients using opioid pain The Senza™ High-Frequency Spinal Cord Stimulation System from Nevro Corp. is limited by U.S. law to investigational use in the U.S. and is not available for commercial sale in the U.S.

Nevro Corp. • 4040 Campbell Ave, Suite 210, Menlo Park, CA 94025 USA • 650-251-0005 10 Ave. Back Pain VAS 8 Ave. Leg Pain VAS 6 4 2 0 Baseline (n=72) 6 Months (n=72) 12 Months (n=59) Both p< 0.001 relative to baseline, 12 mo follow up ongoing. Compare to PROCESS study of traditional SCS Continuing Clinical Evaluation Nevro recently initiated the landmark SENZA-RCT study, a prospective, randomized, controlled U.S. pivotal trial that will enroll up to approximately 300 patients across up to 15 U.S. centers. The study is the first to include active spinal cord stimulation systems in both arms...

Nevro Corp. • 4040 Campbell Ave, Suite 210, Menlo Park, CA 94025 USA • 650-251-0005 The Senza system is a surgically placed device about the size of a stopwatch. It delivers mild electrical signals to the epidural space near the patient’s spine through one or more leads (special medical wires). Before receiving a permanent implant, a trial of HF-SCS with a temporary system is first conducted. If the trial is successful, a stimulator is implanted under the skin of the lower back/buttocks and permanent leads are positioned in the epidural space. The surgery to implant the neurostimulation...