Skip to main content

Dual electrode spinal cord stimulation in chronic leg and back pain

  • Chapter
Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/1))

Summary

Patients with chronic back and leg pain (CBLP) suffer from a disabling spinal condition of multifactorial origin and are often resistant to medical therapy. Spinal cord stimulation (SCS) is a minimally invasive option for treatment of chronic pain in these patients, which involves placement of epidural electrodes close to the midline of the spinal cord. SCS was originally introduced and used for decades with a single electrode. The development of fully implantable dual channel pulse generators connected to dual multicontact electrodes has given pain clinicians a more versatile tool to treat axial low back pain accompanied by radicular neuropathic pain with irregular and asymmetric distribution, a feature which is found in most CBLP patients. It has been hypothesized that using dual electrodes may improve long term outcome for CBLP patients compared with single electrodes. Current evidence however does not lend strong support to this assumption. Given the high cost of treatments for CBLP and of SCS itself, there is an urgent need for highquality evidence for the effectiveness of dual electrode SCS in relieving pain and=or improving function in patients with CBLP.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Barolat G (2000) Spinal cord stimulation for chronic pain management. Arch Med Res 31: 258–262

    Article  PubMed  CAS  Google Scholar 

  2. Burchiel KJ, Anderson VC, Brown FD, Fessler RG, Friedman WA, Pelofsky S, Weiner RL, Oakley J, Shatin D (1996) Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain. Spine 21: 2786–2794

    Article  PubMed  CAS  Google Scholar 

  3. Burton AK, Tillotson KM, Main CJ, Hollis S (1995) Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine 20: 722–728

    Article  PubMed  CAS  Google Scholar 

  4. Cherkin DC, Deyo RA, Loeser JD, Bush T, Waddell G (1994) An international comparison of back surgery rates. Spine 19: 1201–1206

    Article  PubMed  CAS  Google Scholar 

  5. Dario A, Fortini G, Bertollo D, Bacuzzi A, Grizzetti C, Cuffari S (2001) Treatment of failed back surgery syndrome. Neuromodulation 4: 105–110

    Article  Google Scholar 

  6. Devulder J, De Laat M, Rolly G (1998) Dual channel electrostimulation in pain. Acta Neurol Belg 98: 195–198

    PubMed  CAS  Google Scholar 

  7. Krames E (1999) Spinal cord stimulation: indications, mechanism of action, and efficacy. Curr Rev Pain 3: 419–426

    PubMed  Google Scholar 

  8. Kumar K, Malik S, Demeria D (2002) Treatment of chronic pain with spinal cord stimulation versus alternative therapies: costeffectiveness analysis. Neurosurgery 51: 106–116

    Article  PubMed  Google Scholar 

  9. Mailis-Gagnon A, Furlan AD, Sandoval JA, Taylor R (2004) Spinal cord stimulation for chronic pain. Cochrane Database Syst Rev 3: CD003783

    Google Scholar 

  10. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150: 971–979

    Article  PubMed  CAS  Google Scholar 

  11. North RB, Ewend MG, Lawton MT, Piantadosi S (1991) Spinal cord stimulation for chronic, intractable pain: superiority of “multi-channel” devices. Pain 44: 119–130

    Article  PubMed  CAS  Google Scholar 

  12. North RB, Kidd DH, Farrokhi F, Piantadosi SA (2005) Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurgery 56: 98–107

    PubMed  Google Scholar 

  13. North RB, Kidd DH, Olin J, Sieracki JM, Farrokhi F, Petrucci L, Cutchis PN (2005) Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes. Spine 30: 1412–1418

    Article  PubMed  Google Scholar 

  14. North RB, Kidd DH, Piantadosi SA (1995) Spinal cord stimulation versus reoperation for failed back surgery syndrome: a prospective randomized study design. Acta Neurochir [Suppl] 64: 106–108

    CAS  Google Scholar 

  15. North RB, Wetzel FT (2002) Spinal cord stimulation for chronic pain of spinal origin: a valuable long-term solution. Spine 27: 2584–2592

    Article  PubMed  Google Scholar 

  16. Onesti ST (2004) Failed back syndrome. Neurologist 10: 259–264

    Article  PubMed  Google Scholar 

  17. Pearce JM (2000) Aspects of the failed back syndrome: role of litigation. Spinal Cord 38: 63–70

    Article  PubMed  CAS  Google Scholar 

  18. Phillips FM, Cunningham B (2002) Managing chronic pain of spinal origin after lumbar surgery: the role of decompressive surgery. Spine 27: 2547–2554

    Article  PubMed  Google Scholar 

  19. Heidecke V, Rainov NG, Burkert W (2000) Hardware failures in spinal cord stimulation for failed back surgery syndrome. Neuromodulation 3: 27–30

    Article  Google Scholar 

  20. Rutten S, Komp M, Godolias G (2002) Spinal cord stimulation (SCS) using an 8-pole electrode and double-electrode system as minimally invasive therapy of the post-discotomy and post-fusion syndrome — prospective study results in 34 patients. Z Orthop Ihre Grenzgeb 140: 626–631

    Article  PubMed  CAS  Google Scholar 

  21. Slipman CW, Shin CH, Patel RK, Isaac Z, Huston CW, Lipetz JS, Lenrow DA, Braverman DL, Vresilovic EJ Jr (2002) Etiologies of failed back surgery syndrome. Pain Med 3: 200–217

    Article  PubMed  Google Scholar 

  22. Taylor RS, Taylor RJ, Van Buyten JP, Buchser E, North R, Bayliss S (2004) The cost effectiveness of spinal cord stimulation in the treatment of pain: a systematic review of the literature. J Pain Symptom Manage 27: 370–378

    Article  PubMed  Google Scholar 

  23. Taylor RS, Van Buyten JP, Buchser E (2005) Spinal cord stimulation for chronic back and leg pain and failed back surgery syndrome: a systematic review and analysis of prognostic factors. Spine 30: 152–160

    Article  PubMed  Google Scholar 

  24. Turner JA, Loeser JD, Bell KG (1995) Spinal cord stimulation for chronic low back pain: a systematic literature synthesis. Neurosurgery 37: 1088–1096

    Article  PubMed  CAS  Google Scholar 

  25. Turner JA, Loeser JD, Deyo RA, Sanders SB (2004) Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome: a systematic review of effectiveness and complications. Pain 108: 137–147

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag

About this chapter

Cite this chapter

Rainov, N.G., Demmel, W., Heidecke, V. (2007). Dual electrode spinal cord stimulation in chronic leg and back pain. In: Sakas, D.E., Simpson, B.A., Krames, E.S. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/1. Springer, Vienna. https://doi.org/10.1007/978-3-211-33079-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-33079-1_11

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33078-4

  • Online ISBN: 978-3-211-33079-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics