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Updated: May 21, 2026
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Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
Published on: November 21, 2025
Intraoperative neurophysiologic methods for spinal cord stimulator placement under general anesthesia
1Department of Neurosurgery, The Lahey Clinic, 41 Mall Rd., Burlington, MA 01805, USA. jay.shils@lahey.org
Summary
Spinal cord stimulators (SCSs) can be safely and accurately placed under general anesthesia (GA), achieving significant pain reduction. This method ensures stimulation targets the dorsal columns, similar to awake placement.
Area of Science:
- Neurosurgery
- Pain Management
- Neuromodulation
Background:
- Spinal cord stimulation (SCS) is a treatment for chronic pain.
- General anesthesia (GA) has been a concern for SCS placement accuracy.
- Evaluating the precise location and targeted neural structures during SCS is crucial.
Purpose of the Study:
- To assess the safety and accuracy of SCS placement under general anesthesia (GA).
- To validate an evaluation method for confirming dorsal column activation during SCS.
- To compare the efficacy of GA SCS with awake SCS placement.
Main Methods:
- Retrospective analysis of 172 SCS electrode implantations under GA.
- Utilized electromyography (EMG) for intraoperative electrode placement and lateralization.
- Conducted neurophysiologic tests, including paired pulse and collision studies, to confirm dorsal column activation.
Main Results:
- SCS placement under GA was safe, with a 52.11% reduction in Visual Analog Scale (VAS) pain scores.
- Electrode repositioning was necessary in 15.9% of cases based on EMG feedback.
- Neurophysiologic tests confirmed that stimulation activated the dorsal columns, not the corticospinal tract.
Conclusions:
- General anesthesia (GA) SCS placement is a safe and effective alternative to awake procedures.
- The presented evaluation technique accurately confirms dorsal column activation during SCS.
- GA SCS offers comparable accuracy and efficacy to awake SCS placement, with significant pain relief.
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