DUAL-CHANNEL ELECTROSTIMULATION IN PAIN

Spinal cord stimulation is an accepted treatment for neuropathic pain. Technical advances in electrode design and better patient selection h ave led to better and sustained pain control by these devices. Multile ad electrical stimulation is the latest innovation in implantable elec trostimulation (Mattrix, Medtronic Minneapolis, USA). Two combined mul tipolar leads connected to a radiofrequency - coupled system can deliv er electrical pulses of various amplitudes and pulse widths at differe nt dermatome levels. Single stimulation is applied with different elec trode configurations using both electrodes with identical stimulation parameters. In dual stimulation, the amplitude and the pulse width can vary between the electrode configurations. Dual channel stimulation h elps steering stimulation paresthesias. Three patients illustrate the technical advantages of dual channel electrostimulation in the pain re lief at multiple sites. Two patients with failed back surgery syndrome obtained more easily stimulation-induced paresthesias in the back and the legs. Dual channel stimulation is cost saving in patients implant ed with two electrodes. This is presented in a third patient with an e lectrode in the thalamus - as pain treatment for cervicobrachialgia an d a second in the epidural space - as treatment for the failed back su rgery syndrome. These electrodes were connected to the Mattrix stimula tor.