Spinal Cord Stimulation: A Contemporary Series

Spiegelmann, Roberto; Friedman, William A.

doi:10.1227/00006123-199101000-00011

Cited by 90 publications

(40 citation statements)

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“…These data, of course, do not provide detailed insight on the actual therapeutic ef ficacy of the modality, which should take into account all of the previ ously mentioned factors. However, the data agree with previously re ported results of large series [7,9,10).…”

Section: Discussionsupporting

confidence: 92%

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Experience with 509 Plate Electrodes Implanted Epidurally from C1 to L1

Barolat¹

1993

Stereotact Funct Neurosurg

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This article summarizes the experience gained with implantation of 509 plate electrodes performed by a single neurosurgeon. 350 patients were subjected to implantation of plate electrodes in the dorsal epidural space. 227 patients were implanted for chronic pain management (reflex sympathetic dystrophy, failed back syndrome/arachnoiditis, pain following spinal cord injury, nerve injury pain and other miscellaneous pain conditions), 105 patients for motor disorders (spasms/spasticity following spinal cord or head injury, cerebral palsy, multiple sclerosis, spasmodic torticollis and other miscellaneous conditions) and 18 patients for both. A total of 509 electrodes were implanted in the dorsal epidural space. The electrodes types were: 442 Medtronic Resume®, 39 Medtronic Resume-TL® and 25 Neuromed Lamitrode®. 378 electrodes were implanted for chronic pain management, 106 for motor disorders and 25 in patients presenting with both pain and motor disorders. 192 electrodes were implanted in the cervical area and 317 in the thoracic area. 3.7% of the implanted electrodes became infected and had to be surgically removed. Electrode migration occurred in 1.1% of the patients and electrode breakage in 4 patients. 288 (70%) of the implanted electrodes are still being used. Technical factors relevant to the surgical implantation of plate electrodes at various levels in the spine are presented and discussed.

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Section: Discussionsupporting

confidence: 92%

“…Electrode migration has been reported in the literature with rates varying from 3 to 60% [9,10,18,19). In our series electrode migration was minimal.…”

Section: Discussionsupporting

confidence: 48%

Experience with 509 Plate Electrodes Implanted Epidurally from C1 to L1

Barolat¹

1993

Stereotact Funct Neurosurg

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“…The use of plate type electrodes can also contribute to a reduction in the incidence of electrode migration. 76 Average rates of lead breakage and pulse generator complications were found to be respectively 7% and 2%. Burchiel 46 found that in 17% of the patients, the reported complications required surgical intervention.…”

Section: Complications and Side-e Ectsmentioning

confidence: 94%

Spinal cord stimulation in chronic pain syndromes

Vaarwerk

Staal²

1998

Spinal Cord

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Spinal cord stimulation (SCS) has been used for more than 30 years now, and although it has shown to be e ective under certain well-described conditions of chronic pain, conclusive evidence on its e ectiveness is still sparse.There is a need for more prospective and methodological good studies, in order to prove SCS e cacy for new or still questionable indications and to reveal prognostic factors for successful application. Especially at this moment, when governments are trying to control and reduce their health care expenses, studies on the cost-e ectiveness of SCS are important.In contrast to the early years when SCS was applied by independent physicians exploring the ®eld of neurostimulation, the importance of information exchange and coordination of studies has now been recognized. Recent technical improvements of SCS devices may positively in¯uence clinical outcome.

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“…Application of electrical stimulation to the spinal cord (SCS) for alleviating intractable, chronic pain has received wide acceptance (Long and Erickson 1975;Demirel et al 1984;Broseta et al 1986;Meglio et al 1989;Devulder et al 1991;Spiegelman and Friedman 1991). The procedure entails implantation of an array of electrodes either surgically or percutaneously into the dorsal epidural space (Racz et al 1989;Barolat et al 1991).…”

Section: Introductionmentioning

confidence: 99%

Perception Threshold and Electrode Position for Spinal Cord Stimulation

He¹,

Barolat²,

Holsheimer³

et al. 1995

Neurosurgery Quarterly

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SummaryThe perception threshold for epidural spinal cord stimulation in chronic pain management was analyzed on 3923 testing data obtained from 136 implanted patients. The initial areas of paresthesiae due to stimulation were recorded and reported as the stimulation map according to the location of electrodes. Measurement of dorsal thickness of the cerebrospinal fluid (CSF) layer was obtained from 26 subjects using magnetic resonance imaging (MRI). The results indicate that the perception threshold is a function of the spinal level of the implanted electrodes, of the mediolateral position in the spinal canal and the contact separation of electrode. Differences in perception threshold at various vertebral levels are mainly due to varying depths of the dorsal CSF layer. The medially placed electrodes caudal to the mid-cervical levels have a higher perception threshold than more laterally placed ones. The electrodes at high and mid-cervical levels, however, have a smaller perception threshold if placed medially. The information obtained from this investigation has important implications for the design of a new-generation stimulation system and clinical application to maximize the longevity of the power source.

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Spinal Cord Stimulation: A Contemporary Series

Cited by 90 publications

References 0 publications

Experience with 509 Plate Electrodes Implanted Epidurally from C<sub>1</sub> to L<sub>1</sub>

Experience with 509 Plate Electrodes Implanted Epidurally from C<sub>1</sub> to L<sub>1</sub>

Spinal cord stimulation in chronic pain syndromes

Perception Threshold and Electrode Position for Spinal Cord Stimulation

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