Explore the groundbreaking insights from a six-month study on multiarea burst spinal cord stimulation, revealing the connection between intraoperative neuromonitoring, postoperative programming, and clinical outcomes, and how it’s reshaping our approach to neuromodulation therapy.
– by Klaus
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Prospective Six-Month Analysis of Multiarea Burst Spinal Cord Stimulation: Correlating Intraoperative Neuromonitoring With Postoperative Programming and Clinical Outcomes.
Falowski et al., Neuromodulation 2024
<!– DOI: 10.1016/j.neurom.2024.02.003 //–>
https://doi.org/10.1016/j.neurom.2024.02.003
Ho, ho, ho! Gather ’round, my jolly friends, for a tale not of reindeer and sleighs, but of a magical burst of relief known as the DeRidder burst spinal cord stimulation (SCS). In a land not so far away, where chronic pain in the back and legs roams wild like mischievous elves, a group of wise wizards—let’s call them doctors—have been tinkering in their workshops to bring joy and comfort to all.
Now, these wizards discovered that while traditional tonic neurostimulation therapies were like giving coal for Christmas, the DeRidder burst SCS was like the most sought-after toy, offering superior relief from overall pain. But, oh, what to do when the pain is like scattered snowflakes, touching more than one area? Nearly 80% of their patients had such a conundrum, making it tricky to program the stimulation sleigh to deliver long-term efficacy.
Enter the magic of multiple DeRidder burst region programming, a technique as innovative as Rudolph’s red nose, allowing for interleaving stimulation at multiple areas along the spinal cord. Previous adventures in the realm of intraoperative neuromonitoring revealed that DeRidder burst stimulation could cover more ground at a lower recruitment threshold, much like how my sleigh covers the globe in one night.
In a quest to correlate the mystical intraoperative electromyogram (EMG) threshold with postoperative paresthesia thresholds and optimal burst stimulation programming, ten brave souls with chronic intractable back and/or leg pain embarked on a journey. They received a Penta Paddle electrode through a procedure as precise as an elf’s craftsmanship, placed at the T8-T11 spinal levels.
As the story unfolds, these patients were treated with both single- and multiarea DeRidder burst, with intermittent dosing intervals that would make even the most patient elf twitch. The results were as heartwarming as a cup of cocoa by the fireplace. The average decrease in thresholds after a 30-second dose of stimulation was like finding extra presents under the tree, and the pain scores dropped faster than snowflakes on Christmas Eve.
By the end of six months, eight out of ten patients reported a significant decrease in their pain scores, a Christmas miracle indeed! The patient preference leaned towards the two-area DeRidder burst, proving that sometimes, more is merrier.
So, my dear friends, as we wrap up this tale, let’s remember the magic of DeRidder burst SCS in bringing comfort and joy to those with multisite pain. Just like how every snowflake is unique, this study shows that customizing stimulation to each individual can indeed make spirits bright. Merry Christmas to all, and to all a good night!