Spinal Cord Stimulation: The Clinical Application of New Technology

Abstract

The use of neuromodulation for pain relief is among the fastest-growing areas of medicine, involving many diverse specialties and impacting on hundreds of thousands of patients with numerous disorders worldwide. As the evidence of efficacy improves, the interest in spinal cord stimulation (SCS) will increase because it is minimally invasive, safe, and a reversible treatment modality with limited side effect profile. While the mechanism of action evades complete understanding, the technological improvements have been considerable and current neuromodulation developments have been coupled with the rapid growth of the neuromodulation device industry resulting in the development of the next-generation neuromodulation systems. The development, the newest technicaliti and the future for the clinical application of spinal cord stimulation (SCS) are reviewed here.

The Influence of Positioning and Muscle Activity on Motor Threshold during Motor Cortex Stimulation Programming

“…Likely for this same reason, spinal cord stimulators also experience changes in stimulation parameters with changes in patient position. The newest generation of spinal cord stimulators involve technologies that detect, when patients are supine or upright, and can modify current output accordingly [22,23]. An application of similar technologies to MCS may be of benefit to patients.…”

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

“…The conductivity of white matter is highest in the z direction, while in the x and y directions the conductivity is lower and isotropic. Before a unique solution can be calculated for equation (1), boundary conditions need to be set. A zero potential layer is defined around the spinal column model (the surrounding layer) representing distant body tissue.…”

Omurga Hastalıklarının Tedavisinde Algoloğun Rolü

“…Kapı kontrol teorisi, nörotransmiter modülasyonu, sempatik aktivite üzerine etkileri olası etki mekanizmalarıdır. Düşük düzeyde uyarım adrenoreseptör aktivitesini azaltırken, yüksek düzeyde uyarım vazodilatosyon yapmaktadır (42,43). Genel endikasyonları arasında başarısız bel cerrahisi sendromu, periferik iskemi, kompleks bölgesel ağrı sendromu, fantom ağrı, dirençli ve nonoperatif radikülopati, postherpetik nevralji ve dirençli semptomatik iskemik kalp hastalığı sayılabilir (43 …”