Prevention of Mechanical Failures in Implanted Spinal Cord Stimulation Systems

Henderson, Jaimie M.; Oakley, John C.; Schade, C. M.; Sasaki, John; Caraway, David

doi:10.1093/neurosurgery/57.2.414b

Cited by 25 publications

(34 citation statements)

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“…Strategies have been identified to reduce the occurrence of lead migration for SCS implantation [40,41]. In general, it should be appreciated that the propensity of a lead to migrate is influenced by its position in the body.…”

Section: Lead Migrationmentioning

confidence: 99%

“…Given that significantly more movement occurs in the cervical spine versus the thoracic or lumbar spine, a lead placed in the cervical spine is more likely to migrate [42]. The use of at least one strain relief lead coil to minimize the strain placed during spine flexion has been recommended by two panels of experts [40,41]. A computerized model by Henderson et al [41] revealed a 9-cm increase in distance between the implantable pulse generator (IPG) and anchor during spine flexion.…”

Section: Lead Migrationmentioning

confidence: 99%

“…The use of at least one strain relief lead coil to minimize the strain placed during spine flexion has been recommended by two panels of experts [40,41]. A computerized model by Henderson et al [41] revealed a 9-cm increase in distance between the implantable pulse generator (IPG) and anchor during spine flexion. This also reinforces the importance of appropriate lead length selection.…”

Section: Lead Migrationmentioning

confidence: 99%

“…Finally, the IPG location also weighs on the overall strain of the lead. Controversial computerized biomechanical models demonstrated that an abdominal site (for thoracolumbar leads) and a midaxillary site (for cervical leads) were optimal for strain relief [41,42]. However, factors such as appropriate anchoring, strain relief, and patient education may be more important than IPG location.…”

Section: Lead Migrationmentioning

confidence: 99%

See 3 more Smart Citations

Spinal Cord Stimulation: A Review

Compton¹,

Shah

Hayek

2011

Curr Pain Headache Rep

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Spinal cord stimulation (SCS) is a safe and effective treatment of a variety of chronic pain conditions. As our understanding of the mechanisms of action and potential uses of SCS has evolved, clinical and technological advancements have followed. This review provides an overview of potential mechanisms of action of SCS, evidence for its effectiveness, potential complications, and highlights of developing areas of interest.

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Section: Lead Migrationmentioning

confidence: 99%

Section: Lead Migrationmentioning

confidence: 99%

Section: Lead Migrationmentioning

confidence: 99%

Section: Lead Migrationmentioning

confidence: 99%

See 2 more Smart Citations

Spinal Cord Stimulation: A Review

Compton¹,

Shah

Hayek

2011

Curr Pain Headache Rep

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show abstract

“…The most common site of PF and RF in our study was distal to the twist lock anchor, at a point where the twisted lead passes through the deep fascia. This area is subject to maximum stress during spinal movements (13,14). In view of this fact, the senior author had modified the technique of SCS implantation, using a soft plastic flange anchor, coiling a loop of the twisted wires underneath the fascia, and tunneling the lead and lead extender at a horizontal plane in relation to the vertical axis of the spine.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation for Chronic Pain: Causes of Long-Term Paddle-Lead Failure

Akmal

Eljamel

2008

Neuromodulation: Technology at the Neural Interface

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Realistic modeling of deep brain stimulation implants for electromagnetic MRI safety studies

et al. 2018

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We propose a framework for electromagnetic (EM) simulation of deep brain stimulation (DBS) patients in radiofrequency (RF) coils. We generated a model of a DBS patient using post-operative head and neck computed tomography (CT) images stitched together into a “virtual CT” image covering the entire length of the implant. The body was modeled as homogeneous. The implant path extracted from the CT data contained self-intersections, which we corrected automatically using an optimization procedure. Using the CT-derived DBS path, we built a model of the implant including electrodes, helicoidal internal conductor wires, loops, extension cables, and the implanted pulse generator. We also built four simplified models with straight wires, no extension cables and no loops to assess the impact of these simplifications on safety predictions. We simulated EM fields induced by the RF birdcage body coil in the body model, including at the DBS lead tip at both 1.5 Tesla (64 MHz) and 3 Tesla (123 MHz). We also assessed the robustness of our simulation results by systematically varying the EM properties of the body model and the position and length of the DBS implant (sensitivity analysis). The topology correction algorithm corrected all self-intersection and curvature violations of the initial path while introducing minimal deformations (open-source code available at http://ptx.martinos.org/index.php/Main_Page). The unaveraged lead-tip peak SAR predicted by the five DBS models (0.1 mm resolution grid) ranged from 12.8 kW/kg (full model, helicoidal conductors) to 43.6 kW/kg (no loops, straight conductors)at 1.5 T (3.4-fold variation) and 18.6 kW/kg (full model, straight conductors) to 73.8 kW/kg (no loops, straight conductors)at 3 T (4.0-fold variation). At 1.5 T and 3 T, the variability of lead-tip peak SAR with respect to the conductivity ranged between 18% and 30%. Variability with respect to the position and length of the DBS implant ranged between 9.5% and 27.6%.

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Prevention of Mechanical Failures in Implanted Spinal Cord Stimulation Systems

Cited by 25 publications

References 0 publications

Spinal Cord Stimulation: A Review

Spinal Cord Stimulation: A Review

Spinal Cord Stimulation for Chronic Pain: Causes of Long-Term Paddle-Lead Failure

Realistic modeling of deep brain stimulation implants for electromagnetic MRI safety studies

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