Performance of Transverse Tripoles vs. Longitudinal Tripoles With Anode Intensification (AI) in Spinal Cord Stimulation: Computational Modeling Study

Sankarasubramanian, Vishwanath; Buitenweg, Jan R.; Holsheimer, J.; Veltink, Petrus H.

doi:10.1111/ner.12124

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…There are studies analyzing the superiority of the transverse tripole in SCS. 50,56 This configuration requires that three parallel leads are implanted, or a surgical paddle lead is used. We expect that the position of the FSF (the first fiber stimulated at the perception threshold amplitude) could be a good indicator of the area of paresthesia raising the amplitude to the discomfort threshold.…”

Section: Transverse Stimulation: Lateral Displacement Of the Fsfmentioning

confidence: 99%

Effect of Lead Position and Polarity on Paresthesia Coverage in Spinal Cord Stimulation Therapy: A Computational Study

Durá

Solanes

Andrés

et al. 2022

Neuromodulation: Technology at the Neural Interface

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Section: Transverse Stimulation: Lateral Displacement Of the Fsfmentioning

confidence: 99%

Effect of Lead Position and Polarity on Paresthesia Coverage in Spinal Cord Stimulation Therapy: A Computational Study

Durá

Solanes

Andrés

et al. 2022

Neuromodulation: Technology at the Neural Interface

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“…It was designed based on simulation optimizations and the neural activation model of Holsheimer. 13,19,24,25 The model was used to compute the DC fiber and DR recruitment profiles using a variety of bipolar, tripolar, and multipolar configurations. The construction used a novel fusion-bond electrode technology to enable thin electrodes with tighter contact spacing.…”

Section: Hr-scs Paddle Designmentioning

confidence: 99%

High-Resolution Spinal Motor Mapping Using Thoracic Spinal Cord Stimulation in Patients With Chronic Pain

et al. 2022

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BACKGROUND: High-resolution spinal cord stimulation (HR-SCS) paddle can stimulate medialdorsal columns and extend stimulation coverage to the laterally positioned spinal targets. OBJECTIVE: To investigate the medio-lateral selectivity of an HR-SCS paddle in patients with chronic pain. METHODS: During standard-of-care spinal cord stimulation (SCS) placement, epidurally evoked electromyography and antidromic dorsal column-evoked potentials were recorded in 12 subjects using an HR-SCS paddle with 8 medio-lateral sites spanning the full epidural width at thoracic T9-12 and a commercial paddle consecutively. RESULTS: Recruitment maps were aligned with respect to physiological midline which was overlapping with anatomic midline in 10 of 11 cases. Overlapping contacts between the HR-SCS and commercial paddles exhibited similar patterns while HR-SCS demonstrated higher precision targeting of certain dermatomes. Spinal motor maps showed that the lateral contacts triggered stronger responses in medial gastrocnemius, adductor magnus, and tibialis anterior while the medial contacts triggered stronger responses in gluteus maximus and adductor hallucis. The time-locked popliteal fossa responses indicated ipsilateral activation by HR-SCS at the lateral contacts and bilateral activation at the medial contacts with stronger ipsilateral responses. CONCLUSION: This study is the first to perform high-resolution medio-lateral SCS mapping in patients with chronic pain. These results show promise that HR-SCS may provide additional ipsilateral recruitment within the extremities which improve targeting of focal pain in the lower extremities. Furthermore, this study supports the functional use of intraoperative neuromonitoring as a decision tool to determine physiological midline in thoracic SCS surgeries and provides a full methodological framework.

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“…Bipolar or tripolar electrode configurations may improve selectivity of stimulation. Stimulus parameters such as amplitude and pulse width may be used to selectively control which neuronal elements are modulated during stimulation . Nonetheless, conventional dorsal column SCS has many clinical limitations that are currently being investigated.…”

Section: Introductionmentioning

confidence: 99%

Alternate Intraspinal Targets for Spinal Cord Stimulation: A Systematic Review

Chien

Mekhail

2017

Neuromodulation: Technology at the Neural Interface

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Performance of Transverse Tripoles vs. Longitudinal Tripoles With Anode Intensification (AI) in Spinal Cord Stimulation: Computational Modeling Study

Cited by 7 publications

References 28 publications

Effect of Lead Position and Polarity on Paresthesia Coverage in Spinal Cord Stimulation Therapy: A Computational Study

Effect of Lead Position and Polarity on Paresthesia Coverage in Spinal Cord Stimulation Therapy: A Computational Study

High-Resolution Spinal Motor Mapping Using Thoracic Spinal Cord Stimulation in Patients With Chronic Pain

Alternate Intraspinal Targets for Spinal Cord Stimulation: A Systematic Review

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