O098 / #1054 the “neuro-fiber-mapping”: an original concept using live electrostimulation mapping to (re)explore spinal cord neural networks with a focus on the conus medullaris

Spinal Cord (SC) Anatomy is often assimilated to a morphological entity, but its functional anatomy remains poorly understood. We hypothesized that using “super-selective” Spinal Cord Stimulation (SCS), it could be possible to reexplore SC neural networks by performing live electrostimulation mapping. We initiated a systematic lead programming approach on a chronic refractory perineal pain patient, previously implanted with multicolumn SCS at the level of the conus medullaris (T12-L1). It appeared possible: (1) to achieve paresthesia generation and optimized coverage of this patient perineal dermatoma, more selectively than with conventional SCS; (2) to (re)explore the classical anatomy of the conus medullaris using statistical correlations of paresthesia coverage mappings, resulting from 165 different electrical configurations tested.