MULTIFACTORIAL ANALYSIS OF EPIDURAL SPINAL-CORD STIMULATION

In order to provide a data bank to allow a more precise and effective implementation of spinal cord stimulation, a computerized analysis of 1,375 combinations obtained from electrode arrays located in the thoracic and cervical epidural area was performed. 67 electrode arrays implanted in 34 subjects were subjected to analysis. During the stimulation trial, all the available combinations were systematically tested and the results entered into a computerized database. The study was not meant to analyze the clinical results or the indications of epidural spinal cord stimulation. Parameters studied include position of each electrical contact as related to midline, vertebral level of each contact, distribution of stimulation-induced paresthesiae, and electrical parameters (voltage, rate, pulse width, perception threshold, discomfort threshold, usage range). Analysis of the data allow the surgeon (1) to define the characteristics of the stimulation-induced paresthesiae; (2) to define the spectrum of the electrical parameters used to stimulate the spinal cord; (3) to define the population of implanted electrode arrays/contacts; (4) to study objectively how the position of the electrodes within the spinal canal, their vertebral level and the interelectrode distance affect the electrical parameters and the stimulation-induced responses. The multifactorial systematic analysis of such a large number of combinations provides the basis for further developments in the area of electrical stimulation of the nervous system.