Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Chronic Neuropathic Pain

Implanted Devices

What types of SCS electrodes are available for chronic use?

• Percutaneous catheter electrodes designed for permanent use have as many as 16 contacts.  Implantation of a single electrode produces a one-dimensional contact array.  Implantation of multiple electrodes can create a two-dimensional contact array.
• Surgical plate/paddle electrodes have as many as 16 contacts in one- or two-dimensional contact arrays.

What types of stimulator/power generators are available?

Implanted generators are available with three types of power source:

• A radiofrequency receiver with no battery, requiring the patient to wear an external antenna and transmitter during stimulation
• A primary cell that requires surgical replacement when the battery is exhausted
• A rechargeable battery requiring only occasional use of a radiofrequency transmitter

Generators have multiple outputs connected to individual electrode contacts.  Most deliver single-channel (as opposed to multi-channel) stimulation; that is, they cannot simultaneously deliver different voltage or current levels to different electrode contacts, although they might do so sequentially.