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.

• An integrated guide to understanding and implementing spinal cord stimulators (SCS), implantable medical devices used to treat chronic pain of neurologic origin
• Covers all aspects of percutaneous SCS implantation and use from early developments to current operating room techniques, as well as management of potential post-operative complications
• Intended for both surgical and non-surgical pain practitioners

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

Edited by Paul G. Kreis, Professor Emeritus of Anesthesiology and Pain Medicine, University of California, Davis, Edited by Scott G. Pritzlaff, Associate Professor, Department of Anesthesia and Pain Medicine, University of California, Davis, Edited by David J. Copenhaver, Professor and Chief of Pain Medicine, University of California, Davis, Edited by Scott M. Fishman, Professor and Fullerton Endowed Chair in Pain Medicine, University of California, Davis, and Foreword by James E. Boggan, Emeritus Professor and Julian R. Youmans Chair, Department of Neurological Surgery, University of California, Davis

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.

Contributors:

Associate Editors

Charles J. DeMesa, DO, MPH
Associate Professor
Department of Anesthesia and Pain Medicine
University of California, Davis
Sacramento, CA, USA

Ammon A. Hills, DO
Assistant Professor
Departments of Physical Medicine and Rehabilitation and Pain Medicine
Alpine Orthopaedic Specialists
Logan, UT, USA

Michael J. Jung, MD, MBA
Assistant Professor
Department of Anesthesiology and Pain Medicine
University of California, Davis
Sacramento, CA, USA

Ravi Prasad, PhD
Professor and Director of Behavioral Health
Department of Anesthesiology and Pain Medicine
University of California, Davis School of Medicine
Sacramento, CA, USA

Naileshni S. Singh, MD
Associate Professor
Department of Anesthesiology and Pain Medicine
University of California, Davis
Sacramento, CA, USA


Contributors

Julius O. Ebinu, MD, PhD, FRCSC, FACS
Assistant Professor
Department of Neurological Surgery
University of California, Davis
Sacramento, CA, USA

Joseph M. Galante, MD, MBA, FACS
Professor
Department of Surgery
University of California, Davis
Sacramento, CA, USA

Kee D. Kim, MD
Professor and Chief, Spinal Neurosurgery
Department of Neurological Surgery
University of California, Davis Health
Sacramento, CA, USA

Eric O. Klineberg, MD
Professor, Vice Chair, Co-Director of Spine Spine Center
Department of Orthopaedic Surgery
University of California, Davis
Sacramento, CA, USA

J. Anthony Seibert, PhD
Professor
Department of Radiology
University of California, Davis Health
Sacramento, CA, USA

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