1287. Wireless Neurostimulation for SCS, DRG and PNS Indications

Authors: Richard L. Weiner, MD, FAANS (Dallas, TX)

Introduction: Neurostimulation for a variety of chronic pain conditions has traditionally been focused on spinal cord (dorsal column) stimulation for back and/or leg pain unresponsive to other treatment modalities including spine surgery. With recent advances in device hardware and waveform parameters available commercially, the field of chronic pain management as it impacts spine surgery, is realizing new tools to expand indications for treating chronic pain either before or after surgical intervention in the spinal column, dorsal root ganglion and peripheral nerve spaces. Neurosurgeons can now take advantage of these products and easily mastered techniques to offer their patients a variety of treatment options. Methods: New methods of SCS, DRG and PNS neurostimulator implants with technical details will be presented along with expanded indications for these devices. Results: Results from literature and ongoing studies for comparison of DRG vs SCS and PNS along with waveform (tonic vs HF) parameters suggest these newer methods of neurostimulation have a place in the neurosurgical and chronic pain management armamentarium available to the surgeon. Conclusion: Neurosurgeons pioneered spinal cord and peripheral nerve neurostimulation over 50 years ago and are poised to continue development of new techniques and hardware options for chronic pain treatment.