【省立疼痛英语晨读】脊髓电刺激程控：速成课程（一）

 英语晨读 ·

山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。从今天起我们会将晨读内容与大家分享，助力疼痛学习。

本次文献选自Sheldon B , Staudt M D , Williams L , et al. Spinal cord stimulation programming: a crash course[J]. Neurosurgical Review, 2020:1-12.

【Abstract】

The aim of this comprehensive review is to provide an instructional guide for providers regarding the parameters and programming of spinal cord stimulation (SCS) devices. Knowing these fundamentals will aid in providing superior pain relief to patients. SCS has four programmable parameters: contact (electrode) selection, amplitude, pulse width, and frequency. Each parameter needs to be accounted for when assessing which program works for which patient. Traditional open-loop systems allow for different “programs,” or combinations of these four parameters, to be pre-set by the provider and medical device representative. These allow for flexibility in the type of stimulation delivered to the patient depending on activity. Patients are also given control over programs and changing the amplitudes of these programs. However, some open-loop systems place the burden of toggling between programs to manage pain control on patients, though this tends to be less in subparesthesia programs. Newer closed-loop systems make it possible for stimulation settings to automatically adjust in response to accelerometry and evoked compound action potential feedback, and therefore have the potential to streamline the patient experience. This article provides practitioners with the basic knowledge of SCS parameters and programming systems. Understanding their use is essential to providing optimal pain relief to patients.

【Keywords】

Spinal cord stimulation; Waveforms; Programming; Algorithm; Systems

【摘要】

本文旨在为医师认识脊髓电刺激设备的参数及程控提供教学指南。掌握这些基础知识有助于为患者更好的缓解疼痛。SCS有4个可调节参数：触点选择、振幅、脉宽和频率。在为每个患者评估程控时，每个参数都应考虑。传统的开环系统允许医师和器械商预设不同的程序（这四个参数的组合）。这使得医师可以根据患者反应灵活调节刺激类型。患者也可以控制程序的选择以及程控中振幅的大小。然而，一些开环系统将疼痛管理的负担交给了患者，尽管在应用亚感觉异常程序时较少。新的闭环系统可以根据加速计或动作电位反馈自动调节刺激参数，因此可以简化患者的操作。本文为医生介绍SCS参数及程控系统的基础知识。掌握设备的用法对于为患者充分缓解疼痛十分必要。

【关键词】

脊髓电刺激；波形；程控；算法；系统