Spinal Cord Stimulation Percutaneous Implantation Techniques

Neuromodulation therapies such as spinal cord, dorsal root ganglion, and peripheral nerve stimulation are used to treat chronic pain syndromes such as intractable back pain, diabetic neuropathy, spinal radiculopathies, and complex regional pain syndrome. Since the publication of the first edition over a decade ago, there has been unprecedented progress in understanding neuromodulation and technological advances in clinical applications.

Spinal Cord Stimulation is intended as an essential guide to the clinical fundamentals required for safe and effective implantation of neuromodulation devices. Implantation of these devices is performed by physicians from various disciplines, requiring a multidisciplinary skill set that presents a challenge for surgical and non-surgical pain practitioners alike. This authoritative resource integrates the basic multidisciplinary information necessary for understanding spinal cord stimulation, dorsal root ganglion (DRG), and peripheral nerve stimulation (PNS) with up-to-date implantation techniques for clinicians to use in their daily practice. It also features updated advice for appropriate medical decision making, patient education, safe use of radiation, and managing adverse events, with new chapters dedicated toward DRG stimulation and PNS.

Paul G. Kreis, MD, is Professor Emeritus of Anesthesiology and Pain Medicine at the University of California, Davis. Dr. Kreis has a special interest in spinal injections, including selective nerve root blocks, sympathetic blockade, radiofrequency ablation, facet injections and discography.

Scott G. Pritzlaff, MD, is Associate Professor and Director of the Pain Medicine Fellowship in the Department of Anesthesiology and Pain Medicine at the University of California, Davis. Dr. Pritzlaff's research interests focus on emerging technologies to treat peripheral neuropathic pain. He is interested in developing novel uses of percutaneous peripheral nerve stimulation to treat chronic nerve pain.

David J. Copenhaver, MD, MPH, is Professor and Chief of the Division of Pain Medicine and Director of Cancer Pain Management and Supportive Care at the University of California, Davis. Dr. Copenhaver is an anesthesiologist and pain medicine specialist with unique expertise in diagnosing and managing complex pain management problems of various types.

Scott M. Fishman, MD, is Professor of Anesthesiology and Pain Medicine and the Fullerton Endowed Chair in Pain Medicine at the University of California, Davis. Dr. Fishman is continuing his educational and research activities in chronic pain, cancer pain management, psychiatric issues of chronic illness and pain, neuropathic pain treatment strategies, and medical informatics.

Editors and Contributors
Disclosures of Conflicts of Interest

Foreword to the Second Edition
James E. Boggan

Preface
Paul G. Kreis, Scott G. Pritzlaff, David J. Copenhaver, and Scott M. Fishman

Chapter 1 - The Development of Spinal Cord Stimulation
Paul G. Kreis, Ammon A. Hills, and Scott M. Fishman

Chapter 2 - SCS Screening Trial: Patient Selection and Preparation
Paul G. Kreis, Ammon A. Hills, Ravi Prasad, and Scott M. Fishman

Appendix A: Sample Letter of Medical Necessity for Spinal Cord Stimulation
Appendix B: Frequently Asked Questions About Spinal Cord Stimulation
Appendix C: Checklist of Patient Education Topics

Chapter 3 - Radiation Safety
J. Anthony Seibert, Scott M. Fishman, and Paul G. Kreis

Chapter 4 - Sterile Technique
Paul G. Kreis, Ammon A. Hills, and Joseph M. Galante

Chapter 5 - Electricity and Spinal Cord Stimulation
Scott G. Pritzlaff, Ammon A. Hills, and Paul G. Kreis

Chapter 6 - Trial of Spinal Cord Stimulation: Basic Considerations
Scott G. Pritzlaff, Paul G. Kreis, and Scott M. Fishman

Appendix: Sample Dictation--SCS Trial

Chapter 7 - Percutaneous Trial of Spinal Cord Stimulation
Scott G. Pritzlaff, Paul G. Kreis, and Scott M. Fishman

Chapter 8 - Tunneled Trial of Spinal Cord Stimulation
Scott G. Pritzlaff, Paul G. Kreis, and Scott M. Fishman

Chapter 9 - Basic Surgical Skills for the Operating Room
Paul G. Kreis, Julius O. Ebinu, Kee D. Kim, and Eric O. Klineberg

Chapter 10 - Permanent Spinal Cord Stimulator Placement
Scott G. Pritzlaff, Paul G. Kreis, and Scott M. Fishman

Appendix: Sample Dictation Template

Chapter 11 - Wound Healing, Postoperative Wound Management, and Discharge Education
Naileshni Singh, Paul G. Kreis, and Scott M. Fishman

Chapter 12 - Complications and Adverse Events
Naileshni Singh, Paul G. Kreis, and Scott M. Fishman

Chapter 13 - Peripheral Nerve Stimulation
Scott G. Pritzlaff, Ammon A. Hills, Michael Jihnouk Jung, and Charles J. DeMesa

Appendix A: Sample Dictation--PNS Percutaneous Trial/Temporary Implant
Appendix B: Sample Dictation--PNS Permanent Implant

Chapter 14 - Dorsal Root Ganglion Stimulation
Scott G. Pritzlaff, Ammon A. Hills, Michael Jihnouk Jung, and Charles J. DeMesa

Index