Cervical Spinal Cord Stimulation

Chapter 30 Cervical Spinal Cord Stimulation



Note: Please see page ii for a list of anatomical terms/abbreviations used in this book.


Spinal cord stimulation is typically used as a “last resort” for patients who no longer have any other treatment options. It is typically used for patients who have had prior cervical surgery. It is best for patients with a larger component of appendicular as opposed to axial pain. Other indications include complex regional pain syndrome. In Europe, spinal cord stimulation has been described for the treatment of vascular claudication and angina.


The technique described in this chapter follows the algorithm described elsewhere in this book. In particular, we use a trajectory view to identify the oblique and tilt angle (i.e., the entry point) for the placement of the needle. Note that the angle of the needle is as shallow as possible so that the stimulator lead will smoothly exit the needle into the posterior epidural space riding along the patient’s midline until the active electrodes reach the level at which the patient’s pain symptoms are covered, which is often between C4 and C6. To obtain that smooth exit, the needle needs to have a shallow angle relative to the patient (i.e., to be as parallel to the patient’s body as possible). Because we are using trajectory, contralateral oblique, and lateral safety views, it is not necessary to step off of the lamina with the following described technique.


Access to the cervical interlaminar space may be obtained from between C7-T1 through T2-T3.



image Trajectory View (Figure 30–1)



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Dec 23, 2015 | Posted by in INTERVENTIONAL RADIOLOGY | Comments Off on Cervical Spinal Cord Stimulation

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