Spinal Cord Stimulation: Difference between revisions
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The important findings about these paradigms are: | |||
* Tonic Stimulation 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> | * Tonic Stimulation 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> | ||
Revision as of 16:07, 3 March 2024
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Introduction[edit | edit source]
Spinal cord stimulation (SCS) is a surgery that involves implantation of pulse generator that applies electric impulses, and stimulation leads, a cable to connect the leads to a generator, to stimulate the spinal cord for various conditions. [1] Based on the gate control theory of pain, the first device for SCS was introduced in 1968. [2]
Stimulation Paradigms[edit | edit source]
The electrical impulses created by the pulse generator can be modified after the surgery. [1] The stimulation can be applied through different stimulation paradigms including tonic (conventional), burst (also known as paraesthesia-free stimulation) and high-frequency stimulation. [2]
The table below is an example of the frequency, pulse width and amplitude numbers that can be used in the three different modes of the SCS.
| Tonic Stimulation | Burst Stimulation | High Frequency Stimulation | |
|---|---|---|---|
| Frequency | 35-80 Hz | 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. | 10 000 Hz |
| Pulse width | 200-450 μs | 30 ms | |
| Amplitude | 5-6 mA | Low amplitude (approximately 2-3 A) |
The important findings about these paradigms are:
- Tonic Stimulation generates paraesthesia in the target area. [3]
- Burst Stimulation activates some brain areas such as the dorsal anterior cingulate and the dorsolateral precentral cortex. [4]
- Burst Stimulation provides greater pain relief over tonic stimulation. [5]
- High Frequency Stimulation may be more comfortable over tonic stimulation because of the absence of paraesthesia.
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]
Contraindications[edit | edit source]
Physiotherapy Relevance[edit | edit source]
Resources[edit | edit source]
Percutaneous Electrical Nerve Stimulation
References[edit | edit source]
- ↑ 1.0 1.1 Dydyk AM, Tadi P. Spinal cord stimulator implant.
- ↑ 2.0 2.1 2.2 2.3 Pérez JT. Spinal cord stimulation: beyond pain management. Neurología (English Edition). 2022 Sep 1;37(7):586-95.
- ↑ 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.
- ↑ De Ridder D, Plazier M, Kamerling N, Menovsky T, Vanneste S. Burst spinal cord stimulation for limb and back pain. World neurosurgery. 2013 Nov 1;80(5):642-9.
- ↑ 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.
