O2-E-65. Evaluation of spinal dorsal column stimulation using the SEP collision method

• Published in: Clinical neurophysiology 2013-08, Vol.124 (8), p.e33-e33
• Main Authors: Uraski, Eiichirou, Yamakawa, Yuzo, Toyoda, Keisuke, Tsuda, Mami
• Format: Article
• Language: English
• Subjects: Neurology
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2013.02.088

Spinal cord stimulation (SCS) is widely used to control intractable neuropathic pain. To obtain good pain control, appropriate stimulation of the spinal dorsal column is required. In this study, we investigate whether the SEP collision is useful as a way to objectively evaluate spinal dorsal column stimulation, and whether the SEP collision is correlated with the reduction of pain. Nine patients with intractable pain who underwent SCS implantation were evaluated. SEP collision is examined during the recording of cortical SEP components elicited by posterior tibial nerve stimulation. When the SEP amplitude is clearly reduced by the SCS, it is interpreted as a positive collision effect. Intraoperative SEP collision was examined during the electrode placement in the thoracic spinal canal. SEP changes by the stimulation of each electrode column were comparable to the post-operative radiological findings of electrode position on the spinal dorsal column. Seven patients with a positive SEP collision effect revealed pain reduction, but two patients with a negative collision effect showed no pain reduction. In conclusions, SEP collision is a useful objective method for evaluating spinal dorsal column stimulation, and SEP amplitude reduction by the collision method appears to be correlated with the extent of pain control.