Affiliation:
1. Department of Anesthesiology, Rush University Medical Center, Chicago, IL
Abstract
Background: Failed back surgery syndrome is a common clinical entity for which spinal
cord stimulation has been found to be an effective mode of analgesia, but with variable success rates.
Objective: To determine if focal stimulation of the dorsal columns with a transverse tripolar lead might achieve deeper penetration of the electrical stimulus into the spinal cord and
therefore provide greater analgesia to the back.
Design: Case report.
Methods: We describe a 42-year-old female with failed back surgery syndrome that had
greater back pain than leg pain. The tripolar lead configuration was achieved by placing percutaneously an octapolar lead in the spinal midline followed by 2 adjacent quadripolar leads,
advanced to the T7-T10 vertebral bodies.
Results: Tripolar stimulation pattern resulted in more than 70% pain relief in this patient
during the screening trial, while stimulation of one or 2 electrodes only provided 20% pain
relief. After implantation of a permanent tripolar electrode system with a single rechargeable
battery, the pain relief was maintained for one year.
Conclusion: This is case report describing a case of a patient with chronic low back pain
with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar
system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement
may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation
and provide analgesia to the lower back.
Key words: Epidural, low back pain, spinal cord stimulation, failed back surgery syndrome,
tripolar stimulation
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
14 articles.
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