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Spinal Cord Stimulation Efficiency Boosted with Extra Implanted Electrodes
A new study describes a method of electrical stimulation that uses an implanted device with three columns of electrodes, which could increase the efficiency of spinal cord stimulation (SCS) for severe back pain.
Researchers at Poitiers University (France) conducted a study involving 11 patients implanted with a 16-contact spinal cord stimulation lead to assess, through extensive stimulation testing, the capacity of multicolumn tripolar leads to achieve back territory paresthesia coverage in refractory failed back-surgery syndrome patients. A systematic exploration of 43 selected stimulation configurations was used to generate bilateral back paresthesia in addition to leg territory coverage.
The results showed that the tripolar lead configuration successfully generated paresthesia in both bilateral back and leg territories in nine patients (81.8%). Success rates of multicolumn stimulation patterns were significantly higher than for longitudinal configurations for lombodorsal paresthesia coverage. Six months after implantation, significant pain relief was obtained compared with preoperative evaluation for global pain, leg pain, and back pain, as measured on the Visual Analog Scale (VAS). The study was published in the March 2012 issue of Neurosurgery.
“These results suggest that multicolumn leads can reliably generate back pain coverage and favor pain relief outcomes. This may lead physicians to reconsider new indications for spinal cord stimulation,” concluded lead author Philippe Rigoard, MD, and colleagues of the department of neurosurgery. “Expanding neurostimulation perspectives to intractable back pain syndromes could become realistic in the near future.”
For the study, the researchers used the Medtronic (Fridley, MN, USA) Specify 5-6-5 system, which is composed of 16 electrodes in a three-column configuration that offers overlapping areas of stimulation, therefore maximizing the impact of SCS. The tripolar lead configuration and stimulation patterns could potentially help in surpassing restrictions of earlier approaches to SCS, especially for axial pain.