title: Spinal cord stimulation for axial low back pain: a prospective controlled trial comparing 16-contact insulated electrodes with 4-contact percutaneous electrodes.
abstract: Use of multicontact electrodes and programmable implanted pulse generators has increased the efficacy of spinal cord stimulation for pain. Some investigators find dual column electrodes advantageous for difficult-to-treat axial low back pain, but we have reported significantly improved measures with a single percutaneous midline electrode vs. dual percutaneous electrodes and even better results with an insulated, 1 × 4, midline electrode. In this study, 10 patients provided computerized, quantitative parameter measures for a temporary percutaneous 1 × 4 electrode and for a permanent insulated 2 × 8 electrode. Compared with the 2 × 8, the 1 × 4 resulted in marginally better patient-rated (109%, p = 0.06) and computer-calculated pain/paresthesia overlap (107%, p = 0.17); higher scaled amplitude to cover the low back (106%, NS); and significantly lower voltage (78%, p = 0.0004), increased extraneous coverage (141%, p = 0.0000), and improved symmetry (25%, p = 0.001). Thus, we observed no significant technical advantage for the insulated 2 × 8 in treating axial low back pain.
authors.affiliation: Department of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, Md, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: North
authors.forename: David H
authors.initials: DH
authors.lastname: Kidd
authors.forename: John
authors.initials: J
authors.lastname: Olin
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Sieracki
authors.forename: Loredana
authors.initials: L
authors.lastname: Petrucci