Open AccessEffects of Movement and Postural Positions in Spinal Cord Stimulation in the New Rechargeable Systems
Author(s) -
David Abejón,
Pablo Rueda,
E Parodi,
Del Saz J
Publication year - 2014
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.2014/17/345
Subject(s) - supine position , medicine , neurostimulation , spinal cord stimulation , stimulation , sensation , physical medicine and rehabilitation , physical therapy , anesthesia , psychology , neuroscience
Background: Despite recent developments in implantable neurostimulation devices,the adjustment of stimulation levels to the patient’s postural changes has remained aproblem so far.Objective: This study was conducted with the newest rechargeable devices, in orderto compare its results with the ones published from conventional systems.Study Design: It is a prospective study.Setting: In 46 patients implanted with rechargeable constant current stimulationsystems we measured impedance, stimulation thresholds, therapeutic range, as wellpatients’ satisfaction and sensation in 7 different body postures.Results: Data analysis was performed in 46 patients, whose most frequent pathologieswere failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS).The lowest amplitude needed to reach the different thresholds was always scored inthe supine decubitus position, with no significant changes in the therapeutic rangeand impedance. For all stimulation thresholds, there is always a difference between thesupine position and all other postures. No statistically significant differences with regardto patients’ satisfaction and sensation were found for the different postures.Limitations: Sample sample size.Conclusion: The findings of the present work are similar to those described in previouspublications that showed the relationship between postural changes and severalstimulation thresholds and pulse energy. The posture which requires lower energy —and whose corresponding therapeutic range (TR) is narrower — is supine decubitus.Key words: Spinal cord stimulation, change posture, rechargeable systems, sensorgeneration, threshold perception, threshold discomfort