Spinal Cord Stimulation: Difference between revisions
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=== Tonic / Conventional Stimulation === | === Tonic / Conventional Stimulation === | ||
* Generates paraesthesia in the target area. | * Generates paraesthesia in the target area. <ref>Miller JP, Eldabe S, Buchser E, Johanek LM, Guan Y, Linderoth B. Parameters of spinal cord stimulation and their role in electrical charge delivery: a review. Neuromodulation: Technology at the Neural Interface. 2016 Jun 1;19(4):373-84.</ref> | ||
* Frequency: 35-80 Hz | * Frequency: 35-80 Hz | ||
* Pulse width: 200-450 μs | * Pulse width: 200-450 μs | ||
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=== Burst Stimulation === | === Burst Stimulation === | ||
* Also known as paraesthesia-free stimulation. | * Also known as paraesthesia-free stimulation. <ref>Pérez JT. [https://www.sciencedirect.com/science/article/pii/S2173580821000663?via%3Dihub#bib0105 Spinal cord stimulation: beyond pain management]. Neurología (English Edition). 2022 Sep 1;37(7):586-95.</ref> | ||
* Activates some brain areas, including the dorsal anterior cingulate and the dorsolateral precentral cortex. | * Activates some brain areas, including the dorsal anterior cingulate and the dorsolateral precentral cortex. | ||
* Low frequencies (40 Hz) with 5 closely spaced pulses (1 ms) at 500 Hz per burst, or 3 pulses at 100 Hz, followed by a repolarisation phase. | * Low frequencies (40 Hz) with 5 closely spaced pulses (1 ms) at 500 Hz per burst, or 3 pulses at 100 Hz, followed by a repolarisation phase. | ||
* Compared to tonic stimulation, provides a lower charge per pulse and, at the same time, a higher charge per second. The higher charge per second modulates the neurons involved in pain transmission. | * Compared to tonic stimulation, provides a lower charge per pulse and, at the same time, a higher charge per second. The higher charge per second modulates the neurons involved in pain transmission. | ||
* Provides greater pain relief over tonic stimulation in multiple studies. <ref>Kirketeig T, Schultheis C, Zuidema X, Hunter CW, Deer T. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544556/ Burst spinal cord stimulation: a clinical review. Pain Medicine]. 2019 Jun 1;20(Supplement_1):S31-40.</ref> | |||
=== High Frequency Stimulation === | === High Frequency Stimulation === | ||
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* Pulse width: 30 ms | * Pulse width: 30 ms | ||
* Low amplitude (approximately 2-3 A) | * Low amplitude (approximately 2-3 A) | ||
* The advantages over tonic stimulation are still controversial, although it is clear that the absence of paraesthesia may make it more comfortable. | * The advantages over tonic stimulation are still controversial, although it is clear that the absence of paraesthesia may make it more comfortable. | ||
== Indications == | == Indications == | ||
Revision as of 01:58, 29 February 2024
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Description[edit | edit source]
Action Mechanisms[edit | edit source]
Stimulation Paradigms[edit | edit source]
Tonic / Conventional Stimulation[edit | edit source]
- Generates paraesthesia in the target area. [1]
- Frequency: 35-80 Hz
- Pulse width: 200-450 μs
- Amplitude: 5-6 mA
Burst Stimulation[edit | edit source]
- Also known as paraesthesia-free stimulation. [2]
- Activates some brain areas, including the dorsal anterior cingulate and the dorsolateral precentral cortex.
- Low frequencies (40 Hz) with 5 closely spaced pulses (1 ms) at 500 Hz per burst, or 3 pulses at 100 Hz, followed by a repolarisation phase.
- Compared to tonic stimulation, provides a lower charge per pulse and, at the same time, a higher charge per second. The higher charge per second modulates the neurons involved in pain transmission.
- Provides greater pain relief over tonic stimulation in multiple studies. [3]
High Frequency Stimulation[edit | edit source]
- Frequency: 10 000 Hz
- Pulse width: 30 ms
- Low amplitude (approximately 2-3 A)
- The advantages over tonic stimulation are still controversial, although it is clear that the absence of paraesthesia may make it more comfortable.
Indications[edit | edit source]
Indications For Pain Management[edit | edit source]
- Failed back surgery syndrome, radiculopathy, and lumbago
- Complex regional pain syndrome
- Diabetic neuropathy and other neuropathies
- Phantom limb pain
- Angina pectoris and peripheral vascular disease
- Neuropathic pain secondary to tumour
Non-Pain-Related Indications[edit | edit source]
- Parkinson’s disease and other movement disorders
- Spasticity
- Spinal trauma rehabilitation
Resources[edit | edit source]
Percutaneous Electrical Nerve Stimulation
References[edit | edit source]
- ↑ Miller JP, Eldabe S, Buchser E, Johanek LM, Guan Y, Linderoth B. Parameters of spinal cord stimulation and their role in electrical charge delivery: a review. Neuromodulation: Technology at the Neural Interface. 2016 Jun 1;19(4):373-84.
- ↑ Pérez JT. Spinal cord stimulation: beyond pain management. Neurología (English Edition). 2022 Sep 1;37(7):586-95.
- ↑ Kirketeig T, Schultheis C, Zuidema X, Hunter CW, Deer T. Burst spinal cord stimulation: a clinical review. Pain Medicine. 2019 Jun 1;20(Supplement_1):S31-40.
