|
Terms For Comparison
Terms For Link From Comparison of Neurostimulation System Features
Stimulation mode that allows automatic, cycling of multiple stim sets within a program to stimulate different anatomical regions that cannot be captured with a single program. This is a powerful feature provides an advanced treatment option for difficult to treat, multi-location pain patterns. (see Multi-Stim®).
Stimulation mode consisting of a single, continuous stimulation program for less complex or unilateral pain patterns.
This means that electrode combinations can be programmed across multiple leads resulting in a transverse stimulation field
DualStim is a stimulation delivery mode that allows automatic cycling between two stim sets in a single program. In DualStim mode, amplitude, pulse width and electrode polarity are programmed independently for each channel. However, the rate (frequency) is shared and must be set the same for both stim sets.
Refers to the maximum number of electrodes that can be activated. The number of electrodes activated depends upon the condition being treated. For example, more complex pain patterns, such as those involving multiple sites (multi-focal) and multi-extremities involve more nerve structures. Additional electrodes are often to stimulate all of these structures. Implanting fewer electrodes than needed can result in less pain relief.
Refers to the total distance the electrodes on the lead span from one end to the other (measured in millimeters). Lead migration is a common source of reoperation and revision of spinal cord stimulation therapy. Leads with longer electrode span have a greater likelihood that stimulation coverage can be recaptured by electronic repositioning (reprogramming) rather then surgical repositioning.
Metal contacts on the lead through which the electricity travels. The electrode material has different levels of conductivity and thus has an effect of the efficiency of the transfer of electricity. For instance, platinum iridium electrodes have a higher level of conductivity (lower resistance) then nickel alloy electrodes. This means that the transfer of electrical energy is more efficient and should result in a lower level of battery drain for a given stimulation level.
Neurostimulation device consisting of a battery and electronics that are self-packaged in a single metal container. A major advantage of the IPG is that it is totally implanted. The key disadvantage of the IPG is that it has a fixed battery life. When the battery runs out, the IPG needs to be surgically replaced. The primary issue in determining if the IPG is the best option is how long the battery will last given the electrical energy required to attain adequate pain relief. Simple, single extremity pain can often be managed with a minimal number of electrodes, relatively low power output levels, and a single stimulation program and are ideal applications for an IPG. "simple" pain is defined as pain in a single region or a single extremity, which is not expected to migrate, change, or worsen.
Thin cables consisting of metal electrodes at one end connected by wires to an electrical connector at the other. The leads are surgically placed in the space above the spinal cord (epidural space) or near the nerve to be stimulated and connected to the power supply (IPG or RF Receiver).
Refers to the number and type leads that a neurostimulation system can accommodate.
Stimulation mode that allows automatic, cycling of multiple stim sets within a program to stimulate different anatomical regions that cannot be captured with a single program or which require different power settings. Multiple stim sets can be linked together in a program - each with individually adjusted parameters for amplitude, frequency, pulse width and electrode polarity. This feature provides an advanced treatment option for difficult to treat, multi-location pain patterns.
Stimulation mode that allows the user to manually select up to 24 different stimulation programs. This enables the patient to self-regulate therapy and select the best stimulation program for body position for a given moment in time. For example, if the intensity or location of the pain changes throughout the day the patient can select a new program that provides better pain relief for the situation.
Percutaneous leads are leads implanted through a needle without the need for a surgical incision. The advantages of percutaneous leads are that they are less traumatic to implant. Their disadvantages are that they are more prone to move (migrate) as compared to surgical leads and their cylindrical electrode shape makes them less energy efficient.
Stimulation mode that allows the patient to manually select different stimulation programs. This capability enables patients to select the best stimulation program for body position for a given moment in time (see PC-Stim®).
Refers to the number of predefined stimulation programs stored in memory of the neurostimulator. This feature allows programs to be manually selected by the user without having to visit their physician for reprogramming.
Neurostimulation system consisting of an external power source (transmitter) and internal receiver. The key advantage of an RF system is that the batteries are contained in the external transmitter. This replenishable energy source ensures that there is sufficient power to treat the most difficult and complex types of conditions. It also allows special programming that would be impractical to treat with an IPG system. A disadvantage of an RF system is that it requires an external transmitter and antenna. Even though the transmitter is small and can easily pass as a cell phone or pager, dealing with this external component is an issue for some people. However, there are many pain conditions that require the higher electrical energy outputs of an RF system to achieve adequate pain relief. Complex pain is usually better suited to an externally powered radio-frequency (RF) neurostimulator because the power requirements of these pain conditions are almost always much greater than the power requirements of simple, unilateral pain.
Refers to delivery mode for a Medtronic neurostimulators - one program consisting of a single stim set delivered in a continuous mode.
Refers to the spacing or separation between electrodes. Clinical literature shows that the closer the spacing is between electrodes the more precise the stimulation can be targeted to the desired neural structures. This facilitates recruitment of desired nerve fibers before unwanted (and sometimes painful) nerve root stimulation occurs.
Refers to a single group (set) of stimulation parameters consisting of amplitude, frequency, pulse width and electrode polarity. With ANS neurostimulation system, multiple stim sets can be stored in a single program to allow the stimulation to be delivered in a MultiStim mode.
Refers to the number predefined stim sets that can be included in a program. When a stimulation program includes multiple stim sets, the stim sets are automatically cycled to stimulate different anatomical regions that cannot be captured with a single program or which require different power settings. A program with a single stim set delivers the stimulation in a continuous mode.
Refers to the delivery configuration of the stimulation programs. For example, when multiple stim sets are configured in a single program, they are automatically cycled. When a program consists of a single stim set, the stimulation is delivered continuously. Patient-controlled stimulation (PC-Stim) refers to when multiple programs are stored in the neurostimulation that can be manually selected by the user.
An electrical setting that can be adjusted during programming to change the quality, location, intensity and effectiveness of the stimulation sensation. These parameters are amplitude, frequency, pulse width and electrode polarity.
Pre-defined stim parameters (stim sets) stored into the patient programmer or transmitter to provide stimulation to a specific anatomic location. The number of stimulation programs that can be stored in the memory of the neurostimulator depends on the device and is determined by the physician.
Surgical leads, also called paddle leads, are larger leads that require a small surgical incision. Their advantages are that they are less prone to move (migrate) as compared to percutaneous leads, and their flat electrode shape makes them more energy efficient. The disadvantage is that they do require a surgical procedure to place (implant).
There are two types of neurostimulation systems: implantable pulse generator (IPG) and radio frequency (RF). The systems are similar in that they both require at least one implanted lead and an external programmer. They are distinguished from each other by, among other things, the location of the battery.
|
