First Project in Lab: EEG in IONM (pt. 1)

In this post, I will describe the components of the first project that I worked on in the Pilitsis lab.

To frame the concept of this project, I want to give some background on spinal cord stimulation (SCS). SCS is a type of neuromodulation. Neuromodulation is an umbrella term that refers to technology that targets neuropathic pain. Neuropathic pain is nerve pain. SCS involves a permanently implanted device that sends an electrical current to the spine to produce pain relief. SCS can relieve pain in various places in the body, such as the back, low back, groin, legs, or pelvis. SCS has two main hardware components: the electrode or lead (these words can be used interchangeably) and the implantable pulse generator (IPG). The IPG acts as the battery that produces the electrical current, while the lead is what actually delivers the current. There are two basic types of leads: paddle and percutaneous. In the picture below, you can see a paddle lead (percutaneous leads are more slender). The dots on the lead represent contacts, which is where the electrical current is delivered. Accurate lead placement is crucial in relieving pain through SCS. Interestingly, the thickness of a person's cerebrospinal fluid is directly related the voltage needed for adequate pain relief.

Two studies I read in preparation for this study are listed below.

A Prospective Study of the Intra- and Postoperative Efficacy of Intraoperative Neuromonitoring in Spinal Cord Stimulation

Prospective Study of the Use of Intraoperative Neuromonitoring in Determining Post-Operative Energy Requirements and Physiologic Midline in Spinal Cord Stimulation