Theoretical performance and clinical evaluation of transverse tripolar spinal cord stimulation

J.J. Struijk, J. Holsheimer, G.H.J. Spincemaille, F.L.H. Gielen, R. Hoekema

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    41 Citations (Scopus)
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    Abstract

    A new type of spinal cord stimulation electrode, providing contact combinations with a transverse orientation, is presented. Electrodes were implanted in the cervical area (C4-C5) of two chronic pain patients and the stimulation results were subsequently simulated with a computer model consisting of a volume conductor model and active nerve fiber models. For various contact combinations a good match was obtained between the modeling results and the measurement data with respect to load resistance (less than 20% difference), perception thresholds (16% difference), asymmetry of paresthesia (significant correlation) and paresthesia distributions (weak correlation). The transversally oriented combinations provided the possibility to select either a preferential dorsal column stimulation, a preferential dorsal root stimulation or a mixed stimulation. The (a)symmetry of paresthesia could largely be affected in a predictable way by the selection of contact combinations as well. The transverse tripolar combination was shown to give a higher selectivity of paresthesia than monopolar and longitudinal dipolar combinations, at the cost of an increased current (more than twice).
    Original languageEnglish
    Pages (from-to)277-285
    Number of pages9
    JournalIEEE transactions on rehabilitation engineering
    Volume6
    Issue number3
    DOIs
    Publication statusPublished - 1998

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