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Summary of the Day

Perioperative Fluid Administration in Children

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Question of the Day

In the process of placing a spinal cord stimulator, where should the stimulator lead be positioned?

Question of the Day
In the process of placing a spinal cord stimulator, where should the stimulator lead be positioned?
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Explanation

A spinal cord stimulator consists of one or two stimulating leads, placed most often in the posterior epidural space. These leads are connected to an implantable pulse generator. The SCS works by delivering pulses of electrical energy to the dorsal columns of the spinal cord, and has analgesic properties in patients with failed back surgery syndrome, CRPS, neuropathy, and others. Occasionally, the lead can migrate into the anterior epidural space during implantation, but stimulation here would activate motor fibers and is not desired. Intrathecal pump catheters are placed in the intrathecal space. These pumps are used for delivering medicine, most often opioids, into the intrathecal space.

References:

Benzon et al. Raj's Practical Management of Pain. Philadelphia: Mosby Elsevier; 2008: 939-951.

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