Spinal geometry and paresthesia coverage in spinal cord stimulation

被引:66
作者
Holsheimer, J
Barolat, G
机构
[1] Univ Twente, Dept Elect Engn, Inst Biomed TEchnol, NL-7500 AE Enschede, Netherlands
[2] Thomas Jefferson Univ, Dept Neurol Surg, Philadelphia, PA 19107 USA
来源
NEUROMODULATION | 1998年 / 1卷 / 03期
关键词
computer modeling; dorsal column stimulation; dorsal root stimulation; paresthesia mapping; spinal cord stimulation; spinal geometry;
D O I
10.1111/j.1525-1403.1998.tb00006.x
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objective, To test the following hypotheses, based on computer modeling studies of spinal cord stimulation, by the analysis of data from chronic pain patients: I. the probability-of-paresthesia in a dermatome is highest when the cathode is placed at the corresponding segmental level; II. variation of the rostrocaudal position of the cathode in the lower cervical/high thoracic region results in less variation of the probability-of-paresthesia in a dermatome than stimulation in more caudal regions: ill. when stimulating in the midthoracic region, the probability-of-paresthesia in a dermatome is low in comparison to other regions when the cathode is not at the corresponding segmental level. Method. The probability-of-paresthesia in 16 body segments as a function of the rostrocaudal position of the cathode was analyzed from the paresthesia coverage with 3,897 bipolar and unipolar combinations from 106 chronic pain patients. Results, The distributions of the probability-of-paresthesia in the upper and lower limb are in accordance with the hypotheses, but different distributions were found in ail trunk areas. Conclusion. The success to be expected from spinal cord stimulation in chronic pain management is inversely related to the thickness of the dorsal cerebrospinal fluid layer at the cathode level. Therefore, preoperative measurement from transverse images can be helpful as a predictor for success.
引用
收藏
页码:129 / 136
页数:8
相关论文
共 22 条
[1]   Computer assisted and patient interactive programming of dual octrode spinal cord stimulation in the treatment of chronic pain [J].
Alo, KM ;
Yland, MJ ;
Kramer, DL ;
Charnov, JH ;
Redko, V .
NEUROMODULATION, 1998, 1 (01) :30-45
[2]   MAPPING OF SENSORY RESPONSES TO EPIDURAL STIMULATION OF THE INTRASPINAL NEURAL STRUCTURES IN MAN [J].
BAROLAT, G ;
MASSARO, F ;
HE, JP ;
ZEME, S ;
KETCIK, B .
JOURNAL OF NEUROSURGERY, 1993, 78 (02) :233-239
[3]   MULTIFACTORIAL ANALYSIS OF EPIDURAL SPINAL-CORD STIMULATION [J].
BAROLAT, G ;
ZEME, S ;
KETCIK, B .
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 1991, 56 (02) :77-103
[4]   THE DORSAL COLUMNS [J].
DAVIDOFF, RA .
NEUROLOGY, 1989, 39 (10) :1377-1385
[5]   PERCEPTION THRESHOLD AND ELECTRODE POSITION FOR SPINAL-CORD STIMULATION [J].
HE, JP ;
BAROLAT, G ;
HOLSHEIMER, J ;
STRUIJK, JJ .
PAIN, 1994, 59 (01) :55-63
[6]   HOW DO GEOMETRIC FACTORS INFLUENCE EPIDURAL SPINAL-CORD STIMULATION - A QUANTITATIVE-ANALYSIS BY COMPUTER MODELING [J].
HOLSHEIMER, J ;
STRUIJK, JJ .
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 1991, 56 (04) :234-249
[7]   Effect of anode-cathode configuration on paresthesia coverage in spinal cord stimulation [J].
Holsheimer, J ;
Wesselink, WA .
NEUROSURGERY, 1997, 41 (03) :654-659
[8]   Clinical evaluation of paresthesia steering with a new system for spinal cord stimulation [J].
Holsheimer, J ;
Nuttin, B ;
King, GW ;
Wesselink, WA ;
Gybels, JM ;
de Sutter, P .
NEUROSURGERY, 1998, 42 (03) :541-547
[9]  
Holsheimer J, 1997, NEUROSURGERY, V40, P990, DOI 10.1097/0006123-199705000-00023
[10]   Optimum electrode geometry for spinal cord stimulation: the narrow bipole and tripole [J].
Holsheimer, J ;
Wesselink, WA .
MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 1997, 35 (05) :493-497