Spinal Cord Stimulation: Difference between revisions

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=== Burst Stimulation ===
=== Burst 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>
* Also known as paraesthesia-free stimulation. <ref name=":0">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.
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* Phantom limb pain
* Phantom limb pain
* Angina pectoris and peripheral vascular disease
* Angina pectoris and peripheral vascular disease
* Neuropathic pain secondary to tumour
* Neuropathic pain secondary to tumour <ref name=":0" />


=== Non-Pain-Related Indications ===
=== Non-Pain-Related Indications ===
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* Parkinson’s disease and other movement disorders
* Parkinson’s disease and other movement disorders
* Spasticity
* Spasticity
* Spinal trauma rehabilitation
* Spinal trauma rehabilitation <ref name=":0" />


== Resources  ==
== Resources  ==

Revision as of 01:59, 29 February 2024

Original Editor - Sehriban Ozmen

Top Contributors - Sehriban Ozmen  

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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 [2]

Non-Pain-Related Indications[edit | edit source]

  • Parkinson’s disease and other movement disorders
  • Spasticity
  • Spinal trauma rehabilitation [2]

Resources[edit | edit source]

Percutaneous Electrical Nerve Stimulation

References[edit | edit source]

  1. 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.
  2. 2.0 2.1 2.2 Pérez JT. Spinal cord stimulation: beyond pain management. Neurología (English Edition). 2022 Sep 1;37(7):586-95.
  3. 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.