![]() ![]() Spinal cord stimulator electrodes can be placed anywhere along the epidural space from the cervical to the caudal region. The epidural space contains fat, veins, arteries, lymphatics, and connective tissue. The lumbar epidural space is 5 to 6 mm at the L2-元 interspace with the lumbar spine flexed. The cervical epidural space is 3 to 4 mm at the C7-T1 interspace with the cervical spine flexed. The vertebral pedicles and intervertebral foramina form the lateral limits of the epidural space. The epidural space is bounded anteriorly by the posterior longitudinal ligament and posteriorly by the vertebral laminae and the ligamentum flavum. ![]() The epidural space continues inferiorly to the sacrococcygeal membrane. The superior boundary of the epidural space is the fusion of the periosteal and spinal layers of dura at the foramen magnum. Spinal cord stimulator electrodes can be placed into the epidural space either percutaneously or via a small laminotomy. Spinal cord stimulator electrodes can be placed anywhere along the epidural space from the cervical to the caudal region ( Fig. The cervical epidural space contains fat, veins, arteries, lymphatics, and connective tissue. The cervical epidural space is bounded anteriorly by the posterior longitudinal ligament and posteriorly by the vertebral laminae and the ligamentum flavum. The epidural space continues inferiorly to the sacrococcygeal membrane. The superior boundary of the cervical epidural space is the fusion of the periosteal and spinal layers of dura at the foramen magnum. Waldman MD, JD, in Atlas of Interventional Pain Management (Fourth Edition), 2015 Clinically Relevant Anatomy 279 There have been no systematic reviews of spinal cord stimulators in the amplified pain syndromes however, a Cochrane review of cancer-related pain concluded there was insufficient evidence to establish a role of spinal cord stimulators in treating refractory cancer-related pain. 261-278 Olsson reported the use of spinal cord stimulators in seven children two failed to have any benefit, one became infected, and the rest had prolonged relief and the stimulator was eventually removed. 182 There is a high rate of migration of the leads 260 as well as other complications. 259 Wilder reported mild improvement or worsening of pain in 6 children. They are reported to transiently decrease pain but do not prevent the spread of CRPS. BACK STIMULATOR TRIALSpinal cord stimulators are surgically implanted with leads in the epidural space at the level of the spinal cord determined by a trial procedure to decrease pain in the area of amplified pain. Sherry, in Textbook of Pediatric Rheumatology (Seventh Edition), 2016 Spinal Cord Stimulators ![]()
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