Improving Spinal Cord Stimulation With ECAPS
University of Minnesota
Summary
The purpose of this study will be to investigate the optimization of spinal cord stimulation with ECAPs in patients with spinal cord implants.
Description
Spinal cord stimulation (SCS) or electrical stimulation in the epidural space of the spinal canal has been used for more than 50 years to treat chronic pain by modulating the activity of the spinal cord or spinal cord roots. While originally conceived out of gate theory, the precise effects of spinal cord stimulation are still an active area of research. Certainly there are multiple factors contributing to this unchanged responder rate including diagnosis, psychosocial factors, comorbidities, and implementation gaps, but a major technical hurdle remains personalizing therapy to engage in the p…
Eligibility
- Age range
- 22+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Medically stable as determined by the principal investigator * Scheduled to undergo externalization of spinal cord stimulation * English-speaking Exclusion Criteria: * Scheduled for permanent implantation only without trial * Have pacemakers or other neurostimulators * Pregnancy
Interventions
- DeviceSpinal Cord Stimulation
Intraoperatively, stimulation at 12 Hz will be performed as the leads are moved into the targeted position. Amplitude will be increased to 15 mA maximum total until a response is seen on any electrode and held for 10 seconds. Stimulation and recording will be performed using the Neuralynx stim/record system. Post-operatively, the electrodes will be tested for impedance by the clinical system and then they will be connected to the Neuralynx stim/record system. Electrode stimulation patterns will be applied with increasing amplitude until ECAPs responses are seen on recording electrodes. 42 Hz stimulation will be performed with an amplitude sweep of 0mA-10mA. At each amplitude, stimulation will be applied for 4 seconds followed by 2 seconds of rest. Pulse width will be varied from 30-450 microseconds to test effective amplitude. Bursting stimulation will be applied to detect differences in ECAPs as above.
Location
- University of MinnesotaMinneapolis, Minnesota