Artikel
Successful pain relief using Multiple Independent Current Control technology (MICC) and 3D-IlluminaTM programming platform following failure of the conventional SCS systems
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Autoren
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Jaroslaw Maciaczyk
- Abt. Funktionelle Neurochirurgie und Stereotaxie, Neurochirurgische Universitätsklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
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Athanasios Koulousakis
- Abt. Stereotaktische und Funktionelle Neurochirurgie, Neurochirurgische Universitätsklinik, Köln, Deutschland
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Veerle Visser-Vandewalle
- Abt. Stereotaktische und Funktionelle Neurochirurgie, Neurochirurgische Universitätsklinik, Köln, Deutschland
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Jan Vesper
- Abt. Funktionelle Neurochirurgie und Stereotaxie, Neurochirurgische Universitätsklinik, Düsseldorf, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Spinal cord stimulation (SCS) remains an important and clinically validated treatment option for chronic, intractable pain of the back and/or leg(s). Conventional SCS systems on the market are still working with either constant voltage or constant current technology delivering the stimulation from single current source. Others use multiple independent current control technology (MICC) steering each contact individually and apply sophisticated platforms for programming the patients. The latter is supposed to achieve better pain coverage and clinical outcome. The aim of the study was to assess how much the technology can improve the clinical outcomes in patients with unsatisfactory pain relief treated with conventional SCS system, simply by swapping the implantable pulse generator (IPG), in cases where the battery needs to be replaced.
Methods: 4 patients with chronic intractable back and leg(s) pain, who had been initially implanted with Medtronic SCS systems and overall unsatisfactory long-term pain relief, undergone at some time point IPG replacement (3 of them Precision Spectra™ SCS System and one Precision NoviTM(BSC Valencia, CA)) by using a required adaptor either M1 and or M8 (BSC Valencia, CA), without having to change the already implanted lead. Pain coverage percentage and NRS scores were recorded prior and after the replacements.
Results: The mean overall pain coverage across the 4 patients before replacement was 66.3±39%. After replacement was 95±5%. Mean overall pain before replacement was 8±1.4 VAS and after replacement dropped to 5±1.4 VAS. All the patients commented that the paresthesia feeling was more pleasant after the replacement.
Conclusion: In this small cohort we observed that, the usage of the advanced technology of the MICC combined with the Illumina 3D programming platform, allowed to improve the pain coverage and achieve better pain reduction scores. We conclude that in complex cases with unsatisfactory pain relief from conventional SCS systems the technological improvement do significantly influence the clinical outcomes.
