Document Type
Article
Publication Date
6-29-2024
Abstract
INTRODUCTION: In high-frequency spinal cord stimulation anatomic placement targeting of the T9-10 disc space is based on "empiric" results that are best replicated with coverage broadly from T8 to T10. This study contains the largest cohort of patients evaluating low thoracic morphology and seeks to address the lack of MRI morphological analysis in literature.
METHODS: This study was a retrospective review of a database of 101 consecutive patients undergoing permanent implant of thoracic SCS for chronic pain. Measurements were carried out on preoperative MRI imaging. Anteroposterior (AP) and lateral dimensions of the spinal cord as well as dural sac were measured. In addition, dorsal cerebrospinal fluid thickness and paddle depression distance were also measured.
RESULTS: When comparing morphological dimensions by level, dorsal CSF thickness was smaller at T9-10 than T7-8 (p = 0.018). In addition, lateral dural and spinal cord diameters were larger at T10-11 than T9-10, contributing to larger dural surface area at T10-11 (p = 0.028). While trends of dorsal CSF thickness tend to decrease with lower thoracic levels, the ratio of surface area of spinal cord to dural sac appeared to remain relatively constant.
CONCLUSIONS: Dorsal CSF thickness is smaller at T9-10 than T7-8 in chronic pain patients in this cohort. More ellipsoid, cord, and spinal canal diameter measurements were noted at lower levels of the thoracic spinal cord, particularly at T10-11. This may correlate with anatomical SCS placement. Future studies should evaluate efficacy of SCS therapy for pain based on these anatomical considerations.
Recommended Citation
Hines, Kevin; Tran, Christian; Koka, Anusha; Mouchtouris, Nikolaos; Hafazalla, Karim; Hattar, Ellina; Wu, Chengyuan; and Sharan, Ashwini, "Thoracic Canal Morphology on Preoperative Magnetic Resonance Imaging in Spinal Cord Stimulation Patients" (2024). Department of Neurosurgery Faculty Papers. Paper 277.
https://jdc.jefferson.edu/neurosurgeryfp/277
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
38943345
Language
English
Comments
This article is the author’s final published version in Pain Practice, Volume 24, Issue 8, Nov 2024, Pages 1035-1041.
The published version is available at https://doi.org/10.1111/papr.13398. Copyright © 2024 The Author(s). Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.
Publication made possible in part by support through a transformative agreement between Thomas Jefferson University and the publisher.