The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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An Analysis of Paresthesia Areas Evoked by Spinal Cord Stimulation in Relation to the Position of Electrode Tip

척수자극기 전극의 위치에 따른 자극 부위에 대한 분석

  • Lee, Mi Geum (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Lee, Hyo Min (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Jo, Ji Yon (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Choi, Yun Suk (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Ku, Ui Kyoung (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Lee, Chul Joong (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Lee, Sang Chul (Department of Anesthesiology, Seoul National University College of Medicine) ;
  • Kim, Yong Chul (Department of Anesthesiology, Seoul National University College of Medicine)
  • 이미금 (서울대학교 의과대학 마취과학교실) ;
  • 이효민 (서울대학교 의과대학 마취과학교실) ;
  • 조지연 (서울대학교 의과대학 마취과학교실) ;
  • 최윤숙 (서울대학교 의과대학 마취과학교실) ;
  • 구의경 (서울대학교 의과대학 마취과학교실) ;
  • 이철중 (서울대학교 의과대학 마취과학교실) ;
  • 이상철 (서울대학교 의과대학 마취과학교실) ;
  • 김용철 (서울대학교 의과대학 마취과학교실)
  • Received : 2006.09.28
  • Accepted : 2006.11.30
  • Published : 2006.12.30
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Abstract

Background: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. Methods: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. Results: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2⁣-C4 levels. At the upper extremities, paresthesia was evoked in 86⁣-93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7-⁣T12, T10⁣-L1 and T11-⁣L1 vertebral segments, respectively. Conclusions: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.

Keywords

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