Duration of intra-operative stimulation as a predictor of success of spinal cord stimulation for chronic pain syndromes

AIM: Electrical stimulation of the dorsal column of the spinal cord stands out as a major method of neuromodulation. Its popularity stems from the long lasting support to the "gate theory" in which electrical stimulation of the gate prevents passage of nociceptive impulses and reduces pain sensation. There is little known about the effect of the duration of intraoperative stimulation (IOS) trial on the success of the spinal cord stimulation trial. MATERIAL and METHODS: We present our result on 58 patients with spinal cord stimulation implantation and their IOS trials and short-term follow up. RESULTS: The major finding of this study is that the longer the IOS trial, the higher the chances for failure of SCS. Our study also suggests that tripolar spinal cord stimulation leads present a more reliable option for long-term success of the spinal cord stimulation (SCS). CONCLUSION: The duration of IOS seems to influence the result of the initial trial of SCS. IOS should be between 30-60 minutes to optimize the placement of the lead for better correlation with the SCS trial.