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

Paresthesia Coverage

What determines which area is covered by paresthesia?

  • The spinal level of the electrode(s)
  • Position of the electrode with respect to the physiologic midline
  • The distance of the electrode(s) from the spinal cord
  • Individual patient anatomic variance
  • The configuration of the electrode(s) and contacts
  • The stimulation parameters (pulse width, rate, amplitude)
Strength of recommendation Evidence source(s)/rationale
A = Recommended or required
Valid, useful, or non-negotiable
  • Clinical studies
  • Computer modeling studies

Wesselink WA, Holsheimer J, King GW, Torgerson NA, Boom HBK. Quantitative aspects of the clinical performance of transverse tripolar spinal cord stimulation. Neuromodulation 2(1):5-14, 1999.
Abstract | Wikistim Entry

Oakley J, Varga C, Krames E, Bradley K. Real-time paresthesia steering using continuous electric field adjustment. Part I: Intraoperative performance. Neuromodulation 7(3):157-167, 2004.
Abstract | Wikistim Entry

Holsheimer J, Nuttin B, King GW, Wesselink WA, Gybels JM, de Sutter P. Clinical evaluation of paresthesia steering with a new system for spinal cord stimulation. Neurosurgery 42(3):541-547, 1998.
Abstract | Wikistim Entry

Holsheimer J, Wesselink WA. Effect of anode-cathode configuration on paresthesia coverage in spinal cord stimulation. Neurosurgery 41:654-660, 1997.
Abstract | Wikistim Entry

Holsheimer J, Struijk JJ. Effects of electrode geometry and combination on paresthesia coverage and usage range in ESCS. Proceedings of the 2nd Congress of the International Neuromodulation Society, Göteborg, Sweden, 1994.
| Wikistim Entry

Barolat G, Massaro F, He J, Zeme S, Ketcik B. Mapping of sensory responses to epidural stimulation of the intraspinal neural structures in man. Neurosurg 78(2):233-239, 1993.
Abstract | Wikistim Entry