Dual channel electrostimulation in pain.
Spinal cord stimulation is an accepted treatment for neuropathic pain. Technical advances in electrode design and better patient selection have led to better and sustained pain control by these devices. Multilead electrical stimulation is the latest innovation in implantable electrostimulation (Mattrix, Medtronic Minneapolis, USA). Two combined multipolar leads connected to a radiofrequency--coupled system can deliver electrical pulses of various amplitudes and pulse widths at different dermatome levels. Single stimulation is applied with different electrode configurations using both electrodes with identical stimulation parameters. In dual stimulation, the amplitude and the pulse width can vary between the electrode configurations. Dual channel stimulation helps steering stimulation paresthesias. Three patients illustrate the technical advantages of dual channel electrostimulation in the pain relief at multiple sites. Two patients with failed back surgery syndrome obtained more easily stimulation-induced paresthesias in the back and the legs. Dual channel stimulation is cost saving in patients implanted with two electrodes. This is presented in a third patient with an electrode in the thalamus--as pain treatment for cervicobrachialgia and a second in the epidural space--as treatment for the failed back surgery syndrome. These electrodes were connected to the Mattrix stimulator.
Department of Anesthesia, University Hospital Ghent, Belgium.
J
J
Devulder
M
M
De Laat
G
G
Rolly
D000328:Adult; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000628:therapy*; D013118:Spinal Cord Diseases / Q000628:therapy*