High-frequency cervical spinal cord stimulation in spasticity and motor disorders

High frequency stimulation of the cervical spinal cord was used in an attempt to moderate motor disorders in 10 patients, 5 spastics, 3 dystonics and 2 with spasmodic torticollis. Through a C4 flavectomy a quadripolar flat electrode was introduced into the epidural space, placing the first terminal at C2. Electrical parameters for stimulation were established at 0.05-0.10 msec pulse width, rate of 200-1,400 Hz and amplitude to paresthesia threshold. Stimulation was delivered 1 hour on and 1 hour off during daytime. Subjective, clinical and/or neurophysiological initial improvement were initially observed in 9 cases, in which the stimulation system was permanently implanted. After a mean follow-up of 41.4 months all patients but one had a clinical and neurophysiological condition almost similar to the prestimulation one. To investigate the effect of the so-called high-frequency stimulation on the nervous system, 9 dogs were implanted following the same surgical technique and stimulated with analogous electrical parameters than in human practice. After follow-up of 8 months the pathological studies of the animals did not show any local or suprasegmental alterations on nervous structures except a local huge dural scarring reaction.