Transverse tripole (TT) programming allows clinicians to possibly increase back stimulation field by avoiding stimulation in the dorsal roots thereby controlling boundaries of the stimulation field. A case-study is presented to illustrate the benefits of TT programming.

Materials and Methods

Data is being collected from an ongoing clinical research study being conducted with patients implanted with the Eon® Neurostimulation System (ANS; Plano, TX). This study is a prospective, multi-centered, 2-year post-initial programming study. After informed consent is obtained, patients are evaluated prior to system implant. Patients return for evaluation at 1, 3, and 6 months; 1 year, 18 months, and 2 years post implant. The following parameters are evaluated: pain relief, satisfaction level, area of paresthesia coverage of their painful area, lead placement, device programming, quality of life, and disability.

Results

Baseline pain peaked at 5 inches above the iliac crest along the spine descending to 2 inches above the iliac crest on the right and left side of the back. At the one month visit the patient had two programs, a TT and a guarded cathode on the midline lead (GC). The GC provided stimulation up to the iliac crest on a back grid and only through the upper buttocks on an anatomical chart. The TT program gave stimulation up to 6 inches at center, 1 inch at left, and 4 inches at right back above the iliac crest. The patient also indicated stimulation in the lower axial back on the anatomical chart. The GC program was only able to provide 50% coverage of the initial pain region, whereas the TT program provided 93.3% coverage. Furthermore, the patient reported a 100% pain relief in the back at one month.

Conclusion

This case-study illustrates a possible programming option with TT programming for increasing stimulation coverage. Further investigation is needed.