Optimization of Intradural Spinal Cord Stimulator Designs via Analysis of Thoracic Spine Imaging Data

Axial magnetic resonance images of the thoracic spinal cord of 50 patients are analyzed in order to measure the length of the dorsal arc span between the dorsal root entry zones for the purpose of optimizing the mechanical design dimensions of the Human Spinal Cord Modulation System (HSCMS), which delivers electrical stimuli directly to the spinal cord. Two mathematical approaches are used to assess the data, with validation of the results conducted via a direct physical measurement using a magnified image. Results show that the nominal value of the arc length is 6.7 ± 1.0 mm (1 σ), with high and low values of 8.8 and 5.1 mm, respectively. The mean radius of the spinal cord was found to be 3.6 ± 0.5 mm. Taking into account previously reported measurements, it is suggested that values at the high end of this range be used for further morphometric studies of the cord in the thoracic region. The implications of these findings on the design of the HSCMS are discussed.

[1]  Spinal Cord Stimulation , 2020, Definitions.

[2]  L. Claeys,et al.  Spinal cord stimulation , 2007, Spinal Cord.

[3]  Oliver E. Flouty,et al.  Ovine Tests of a Novel Spinal Cord Neuromodulator and Dentate Ligament Fixation Method , 2012, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[4]  Oliver E. Flouty,et al.  A new device concept for directly modulating spinal cord pathways: initial in vivo experimental results , 2012, Physiological measurement.

[5]  P. Veltink,et al.  Triple Leads Programmed to Perform as Longitudinal Guarded Cathodes in Spinal Cord Stimulation: A Modeling Study , 2011, Neuromodulation : journal of the International Neuromodulation Society.

[6]  George T. Gillies,et al.  Intradural approach to selective stimulation in the spinal cord for treatment of intractable pain: Design principles and wireless protocol , 2011 .

[7]  J. Sasaki,et al.  Assessment of Patient Preference for Constant Voltage and Constant Current Spinal Cord Stimulation , 2010, Neuromodulation : journal of the International Neuromodulation Society.

[8]  E. Buchser,et al.  An Analysis of the Components of Pain, Function, and Health‐Related Quality of Life in Patients with Failed Back Surgery Syndrome Treated with Spinal Cord Stimulation or Conventional Medical Management , 2010, Neuromodulation : journal of the International Neuromodulation Society.

[9]  Marjolein P. Hilgerink,et al.  ELECTRODE CONTACT CONFIGURATION AND ENERGY CONSUMPTION IN SPINAL CORD STIMULATION , 2009, Neurosurgery.

[10]  A. Duenas,et al.  Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation. , 2009, Health technology assessment.

[11]  Richard B. North,et al.  Neural Interface Devices: Spinal Cord Stimulation Technology , 2008, Proceedings of the IEEE.

[12]  E. Buchser,et al.  Spinal cord stimulation versus conventional medical management for neuropathic pain: A multicentre randomised controlled trial in patients with failed back surgery syndrome , 2007, Pain.

[13]  P. Wieringa,et al.  The anatomy of the thoracic spinal canal investigated with magnetic resonance imaging (MRI). , 2007, Acta anaesthesiologica Belgica.

[14]  J. Henderson,et al.  Failure modes of spinal cord stimulation hardware. , 2006, Journal of neurosurgery. Spine.

[15]  E. Buchser,et al.  Spinal Cord Stimulation for Chronic Back and Leg Pain and Failed Back Surgery Syndrome: A Systematic Review and Analysis of Prognostic Factors , 2005, Spine.

[16]  T. Cameron,et al.  Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. , 2004, Journal of neurosurgery.

[17]  Jan Holsheimer,et al.  New Trends in Neuromodulation for the Management of Neuropathic Pain , 2002, Neurosurgery.

[18]  J. Holsheimer Which Neuronal Elements are Activated Directly by Spinal Cord Stimulation , 2002, Neuromodulation : journal of the International Neuromodulation Society.

[19]  Jan Holsheimer,et al.  Computer modelling of spinal cord stimulation and its contribution to therapeutic efficacy , 1998, Spinal Cord.

[20]  J. Holsheimer,et al.  Optimum electrode geometry for spinal cord stimulation: The narrow bipole and tripole , 1997, Medical and Biological Engineering and Computing.

[21]  H. Matsuzaki,et al.  The origin and significance of spinal cord pulsation , 1996, Spinal Cord.

[22]  J Holsheimer,et al.  MR assessment of the normal position of the spinal cord in the spinal canal. , 1994, AJNR. American journal of neuroradiology.

[23]  A. Kopf,et al.  Verification of a formula for determination of preexcision surgical margins from fixed-tissue melanoma specimens. , 1992, Journal of the American Academy of Dermatology.

[24]  H. Ko,et al.  Gross quantitative measurements of spinal cord segments in human , 2004, Spinal Cord.