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Analysis of current density and related parameters in spinal cord stimulation.

A volume conductor model of the spinal cord and surrounding anatomical structures is used to calculate current (and current density) charge per pulse, and maximum charge density per pulse at the contact surface of the electrode in the dorsal epidural space, in the dorsal columns of the spinal cord and in the dorsal roots. The effects of various contact configurations (mono-, bi-, and tripole), contact area and spacing, pulsewidth and distance between contacts and spinal cord on these electrical parameters were investigated under conditions similar to those in clinical spinal cord stimulation. At the threshold stimulus of a large dorsal column fiber, current density and charge density per pulse at the contact surface were found to be highest (1.9.10(5) microA/cm2 and 39.1 microC/cm2.p, respectively) when the contact surface was only 0.7 mm2. When stimulating with a pulse of 500 microseconds, highest charge per pulse (0.92 microC/p), and the largest charge density per pulse in the dorsal columns (1.59 microC/cm2. p) occurred. It is concluded that of all stimulation parameters that can be selected freely, only pulsewidth affects the charge and charge density per pulse in the nervous tissue, whereas both pulsewidth and contact area strongly affect these parameters in the nonnervous tissue neighboring the electrode contacts.