Differences in EEG patterns between tonic and high frequency spinal cord stimulation in chronic pain patients.

Objective: To investigate the differences in neural patterns between spinal cord stimulation (SCS) waveforms (60-Hz tonic vs 10-KHz high frequency stimulation, HFS) and their correlation to stimulation-induced pain relief.

Methods: We recorded 10-channel electroencephalogram (EEG) in response to stimulation ON and OFF in 9 chronic pain patients (4 women, 5 men) during SCS surgery and examined the intraoperative spatio-spectral EEG features.

Results: We discovered stronger relative alpha power in the somatosensory region and higher trend in alpha/theta peak power ratio in frontal cortex with HFS.

Intraoperative Neuromonitoring in Percutaneous Spinal Cord Stimulator Placement.

Introduction: Placement of spinal cord stimulation (SCS) paddles under general anesthesia using intraoperative neuromonitoring (IONM) has been shown to be associated with equivocal or superior clinical outcomes in comparative studies. The value of IONM in percutaneous permanent SCS placement has not been demonstrated.

Methods: Outcomes for patients under percutaneous SCS placement performed with IONM were prospectively collected.

Prospective Study of the Use of Intraoperative Neuromonitoring in Determining Post-Operative Energy Requirements and Physiologic Midline in Spinal Cord Stimulation.

Background: Intraoperative neuromonitoring (IONM) through electromyography (EMG) studies has been shown to be a safe, effective way to determine the laterality of the spinal cord and guide electrode placement during spinal cord stimulation (SCS). However, the use of IONM to predict post-operative energy requirements and midline has not been examined and offers a new avenue to streamline programming and device selection. Further, the impact of cerebrospinal fluid (CSF) thickness on intraoperative and post-operative amplitudes is understood but has not been explicitly characterized.

A Prospective Study of the Intra- and Postoperative Efficacy of Intraoperative Neuromonitoring in Spinal Cord Stimulation.

Background: Accurate lead placement is critical for spinal cord stimulation (SCS) efficacy. The traditional gold standard of awake placement is often technically difficult. While there is retrospective evidence supporting the use of intraoperative neurophysiological monitoring (IOM) as an alternative, a prospective assessment has not yet been performed.