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Burst Spinal Cord Stimulation: Toward ParesthesiaFree Pain Suppression

De Ridder, Dirk MD, PhD; Vanneste, Sven PhD; Plazier, Mark MD; van der Loo, Elsa MSc; Menovsky, Tomas MD, PhD

Neurosurgery:
doi: 10.1227/01.NEU.0000368153.44883.B3
Concepts and Innovations
Abstract

INTRODUCTION: Spinal cord stimulation is commonly used for neuropathic pain modulation. The major side effect is the onset of paresthesia. The authors describe a new stimulation design that suppresses pain as well as, or even better than, the currently used stimulation, but without creating paresthesia.

METHODS: A spinal cord electrode (Lamitrode) for neuropathic pain was implanted in 12 patients via laminectomy: 4 at the C2 level and 7 at the T8–T9 level for cervicobrachialgia and lumboischialgia, respectively (1 at T11 at another center). During external stimulation, the patients received the classic tonic stimulation (40 or 50 Hz) and the new burst stimulation (40-Hz burst with 5 spikes at 500 Hz per burst).

RESULTS: Pain scores were measured using a visual analog scale and the McGill Short Form preoperatively and during tonic and burst stimulation. Paresthesia was scored as present or not present. Burst stimulation was significantly better for pain suppression, by both the visual analog scale score and the McGill Short Form score. Paresthesia was present in 92% of patients during tonic stimulation, and in only 17% during burst stimulation. Average follow-up was 20.5 months.

CONCLUSION: The authors present a new method of spinal cord stimulation using bursts that suppress neuropathic pain without the mandatory paresthesia. Pain suppression seems as good as or potentially better than that achieved with the currently used stimulation. Average follow-up after nearly 2 years (20.5 months) suggests that this stimulation design is stable.

Author Information

BRAI2N, Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium

Reprint requests: Dirk De Ridder, MD, PhD, BRAI2N, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium. E-mail: Dirk.De.Ridder@uza.be

Received, February 28, 2009.

Accepted, November 30, 2009.

Copyright © by the Congress of Neurological Surgeons