title: Real-Time Paresthesia Steering Using ContinuousElectric Field Adjustment. Part I: IntraoperativePerformance.
abstract: We present data collected from a multicenter study using a new neurostimulation system. This new system uses a current-shifting programming technique for spinal cord stimulation. The system maintains a continuous, suprathreshold stimulation field while adjusting the distribution of anodic and cathodic current among contacts along a multi-contact array. The changing distribution of current shifts the electric field along the spinal cord, resulting in real-time, dynamic paresthesia steering. This process of adjusting the stimulation field has been termed continuous electric field adjustment (CEFA). This technique has been used to assess paresthesia coverage for patients undergoing implantation of stimulation contact arrays for chronic pain. This multicenter study evaluated the performance of the CEFA technique. The results of the study showed that paresthesia coverage could be shifted in real-time to different regions on the patient's body in a comfortable fashion, with the patient always feeling paresthesia during the adjustment process. The results of the study also show that the process was time-efficient: intraoperatively, the median time to assess 71 combinations on a single 8-contact lead across 18 patients was 4.1 (3.6-5.0) minutes.
authors.affiliation: Yellowstone Neurosurgical Associates, Billings, Montana;              Pasadena Rehabilitation Institute, Pasadena, California;              Pacific Pain Treatment Center, San Francisco, California; and              Advanced Bionics Corporation, Valencia, California.
authors.forename: John
authors.initials: J
authors.lastname: Oakley
authors.forename: Clayton
authors.initials: C
authors.lastname: Varga
authors.forename: Elliot
authors.initials: E
authors.lastname: Krames
authors.forename: Kerry
authors.initials: K
authors.lastname: Bradley