Open AccessImportance of Axial Migration of Spinal Cord Stimulation Trial Leads with Position
Author(s) -
Chong H. Kim,
Adam W. Green,
Drew E Rodgers,
Mohammed Issa,
Monica A Ata
Publication year - 2013
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2013/16/e763
Subject(s) - medicine , sitting , stimulation , clinical trial , spinal cord stimulator , physical medicine and rehabilitation , spinal cord , spinal cord stimulation , anesthesia , randomized controlled trial , physical therapy , surgery , pathology , psychiatry
Background: Spinal cord stimulation (SCS) is an established treatment option for chronic pain.Prior to permanent implantation, temporary trials are performed to evaluate the SCS treatment.During the trial period, it is common for the patients to experience changes in paresthesias.However, it is unclear what the role of lead migration is, if any, in the changes in paresthesia.Objective: To evaluate the role of lead migration on the effect of postural stimulation changesduring SCS trials.Study Design: Case series.Setting: University pain management center.Methods: X-rays of the patients with successful trials, in sitting and standing position, wereobtained at the end of a 7 day SCS trial. Data were collected based on the need for adjustmentof the stimulation settings due to changes in paresthesias with postural change of sitting versusstanding.Results: The average lead migration was 3.05 mm inferiorly from a standing to sitting positionfor all subjects. The average migration was 2.85 mm in subjects requiring adjustment of theSCS setting due to change in paresthesia compared to 3.24 mm for those who did not requireadjustment regardless of position. The results were insignificant based on P = 0.17.Limitations: Small sample size, case series.Conclusions: This case series demonstrates continued support for the role of the width of thecerebral spinal fluid space as the significant factor on paresthesia changes in SCS with respect topostural changes, even during the trial period.Key words: Spinal cord stimulation, postural change, lead migration, paresthesia,neurostimulation, chronic pain, dorsal column