Katie RousseauErich Richter, M.D.

LSU Health Sciences Center, New Orleans

Spinal Cord StimulationImportant treatment for chronic neuropathic

back and leg painSCS has traditionally been more effective for

the treatment of leg pain than for low back pain1

Current techniquesClinical efficacy

depends on paresthesia coverage of the painful area

There are several techniques for implantationAwake placementGeneral anesthesia

with fluroscopyGeneral anesthesia

with EMG mapping

ObjectiveIf a patient has low back paresthesia with a

specific set of stimulation parameters when prone, how likely are they to still have low back paresthesia with the same stimulation parameters when they are sitting?

Determine the predictive value of prone low back paresthesia for sitting low back paresthesia

MethodsPatients were examined at routine follow up

after implantation of permanent paddle leadA series of programming combinations was

tested to determine which combinations gave low back paresthesia coverage while prone

These combinations were then tested in the sitting position to determine if they still gave low back coverage

8 males, 3 females, ages 44 to 81

Example 1: Prone

Example 1: Sitting

Legend:L: leftR: right0: no paresthesia1: paresthesia present

Example 1: Graph

Legend:L: leftR: right0: no paresthesia1: paresthesia present

Example 2: Graph

Results

Only 58.1% of the settings that generated paresthesia in the low back in the prone position also generated the same coverage while upright

However, successful coverage could be reliably found in all patients when using an electrode with coverage redundancy

ConclusionsSpecific electrode combinations producing

paresthesia in the low back in the prone position are unreliable at producing the same pattern when sitting

This may have implications for intraoperative physiologic mapping

However, it appears possible to capture the low back with moderate programming changes

AcknowledgementsFunded by Alpha Omega Alpha’s Carolyn L.

Kuckein Student Research Fellowship

Questions?