Multiple-Lead Spinal Cord Stimulation: Technique

Abstract

This report is a continuation of our previous report on chronic spinal cord stimulation in disorders of the motor system. Improved statistics were observed following changing from the early conventional two-electrode system to a newly developed four-electrode system. The success of the four-electrode system lies in the analysis of both the electrode combinations and the frequency of stimulation. These are carried out on each patient and remain the most critical aspects of the technique. The details of the multiple lead system – the technique of implantation and protocols for carrying out electrode and frequency analysis – are presented.

Surgical treatment of painful spasticity after spinal cord injury

“…This has led to search for other, non-destructive methods of treatment for painful spasticity. Of these intrathecal administration of baclofen, hypothermia of the spinal cord 1,2 and spinal cord electrostimulation 3,4,5,6 are of great interest.…”

“…3,5,6 The implantation of stimulating electrodes over the cerebellar vermis or dorsal spinal cord presumably stimulates inhibitory pathways and inhibits facilatory pathways. Long-term follow-up studies have not been encouraging, perhaps because of equipment failure and electrode impairment by ®brosis.…”

“…There are several conservative methods of painful spasticity treatment: spinal cord hypothermia, 1,2 electrical stimulation 3,4,5,6 intrathecal introduction of baclofen 7 and intrathecal phenol block. 8 However, conservative methods do not always provide long-term and complete antispastic e ects in cases of spinal cord injury with severe painful spasticity.…”

Spinal Cord Stimulation in the Treatment of Spasmodic Torticollis

“…From 1978 to 1979 the four-electrode system was implanted in the cervical area through a simple laminectomy placed in the epidural space in the midline under direct vision [9]. Since, we have used a percutaneous technique (9,12) in which four electrodes are incorporated into a thin catheter system which can be inserted through a single 16-gauge epidural needle.…”

“…Since, we have used a percutaneous technique (9,12) in which four electrodes are incorporated into a thin catheter system which can be inserted through a single 16-gauge epidural needle. The multielectrode assembly consists of four platinum elec trodes, 4 mm in length, 1.2 mm in diameter and spaced 6 mm apart (1 cm center to cen- …”