![]() Some published reports suggested that there was therapeutic value in having a stimulation pulse width (PW) of long duration. Over the past four decades, improvements have been made in both the clinical and technical aspects of SCS, including patient screening and follow-ups, and equipment design and functionality. to introduce spinal cord stimulation (SCS) as a treatment for chronic neuropathic pain in 1967. In 1965, Melzack and Wall proposed the gate control theory of pain, which paved the way for Shealy et al. It is concluded that the computational SCS model is a valuable tool to understand basic mechanisms of nerve fiber excitation modulated by stimulation parameters such as PW and electric fields. Thus, variable PW programming in SCS appears to have theoretical value, demonstrated by the ability to increase and even ‘steer’ spatial selectivity of dorsal column fiber recruitment. These modeling results were validated by a companion clinical study. Mathematical modeling suggested that mediolateral lead position may affect chronaxie and rheobase values, as well as predict greater activation of medial dorsal column fibers with increased PW. The computational model was composed of a finite element model for structure and electrical properties, coupled with a nonlinear double-cable axon model to predict nerve excitation for different myelinated fiber sizes. ![]() ![]() To understand the theoretical effects of pulse width (PW) programming in spinal cord stimulation (SCS), we implemented a mathematical model of electrical fields and neural activation in SCS to gain insight into the effects of PW programming. ![]()
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