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Spinal cord implants

Sameer Jain, Michael A Fishman, Chengyuan Wu
Spinal cord stimulation has been an effective therapy for treatment of chronic low back pain over the last four decades. Over the years, there have been significant technological advances in the neuromodulation devices. Externally powered neuromodulation devices, that do not require an internal pulse generator (IPG) implantation, have recently been approved for treatment of chronic pain and the data on potential pitfalls and unforeseen complications with these devices is minimal. Here, we report a case of a 60-year-old woman with chronic back pain who underwent the implantation of one of such devices and developed complication that required neurosurgical intervention...
September 21, 2018: BMJ Case Reports
Haiping Xu, Baisong Zhao, Yingjun She, Xingrong Song
Dexmedetomidine, a selective α2 adrenergic agonist, has been shown to have neuroprotective and anti-apoptotic effects. To further investigate the underlying mechanisms, we used a rat model of spinal neurotoxicity induced by intrathecal administration of lidocaine. Four days after intrathecal catheter implantation, rats received an intraperitoneal injection of various doses of dexmedetomidine before an intrathecal injection of 20 µL 10% lidocaine. Dexmedetomidine-pretreated rats were also exposed to a selective α2 -adrenergic antagonist (yohimbine) or a specific protein kinase C (PKC) inhibitor (Gö 6983) that selectively inhibits several PKC isoforms...
September 18, 2018: Neurotoxicology
Weibin Shi, Shannon Schultz, David R Gater
Following spinal cord stimulator (SCS) implantation, post-operative pain is commonly incisional or neuropathic from neurological damage. Occasionally, this new pain may mimic symptoms due to pre-existing pathology. We present a case of immediate, severe, post-operative leg pain secondary to a lower extremity deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) after percutaneous SCS implantation for failed back syndrome. The risk factors of DVT after spine surgery and perioperative prophylaxis will be further discussed with a brief literature review...
September 11, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
M L Yang, H M Zhao, J J Li, D G Yang, Q Wang, L J Gao, W P Deng, L J Du, H M Gong, L Chen, Y M Wang, Y M Jian, J Li
Objective: To report the use of implantable diaphragm pacer (IDP) in a patient with high cervical spinal cord injury(HCSCI). Methods: A 14-year-old male patient, who suffered from a HCSCI at C2 neurological level and had been on a ventilator for 2 years, received IDP in August 2017 at China Rehabilitation Research Center. A systematic literature review was performed on IDP in patients with HCSCI in Pubmed, CNKI, and Wanfang databases, using the keywords: phrenic nerve and electrical stimulation and spinal cord injury; IDP and spinal cord injury; breathing pacemaker system and spinal cord injury...
September 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Raymond P Onders, MaryJo Elmo, Cindy Kaplan, Robert Schilz, Bashar Katirji, Glen Tinkoff
BACKGROUND: Cervical spinal cord injury can result in catastrophic respiratory failure requiring mechanical ventilation with high morbidity, mortality, and cost. Diaphragm pacing was developed to replace/decrease mechanical ventilation. We report the largest long-term results in traumatic cervical spinal cord injury. METHODS: In this retrospective review of prospective institutional review board protocols, all patients underwent laparoscopic diaphragm mapping and implantation of electrodes for diaphragm strengthening and ventilator weaning...
September 5, 2018: Surgery
Nagy Mekhail, Gerges Azer, Youssef Saweris, Diana S Mehanny, Shrif Costandi, Guangmei Mao
BACKGROUND AND OBJECTIVES: Despite the observation that select nicotine receptor agonists have analgesic effects, smokers report higher pain scores and more functional impairments than lifelong nonsmokers, attributable to exaggerated stress responses, receptor desensitization, and altered pharmacokinetics compounded by accelerated structural damage resulting from impaired bone healing, osteoporosis, and advancement of disk disease. We hypothesized that smoking diminishes the analgesic response to spinal cord stimulation (SCS) in patients with chronic spine-related pain conditions...
September 5, 2018: Regional Anesthesia and Pain Medicine
Marco Capogrosso, Fabien B Wagner, Jerome Gandar, Eduardo Martin Moraud, Nikolaus Wenger, Tomislav Milekovic, Polina Shkorbatova, Natalia Pavlova, Pavel Musienko, Erwan Bezard, Jocelyne Bloch, Grégoire Courtine
Epidural electrical stimulation (EES) of the spinal cord and real-time processing of gait kinematics are powerful methods for the study of locomotion and the improvement of motor control after injury or in neurological disorders. Here, we describe equipment and surgical procedures that can be used to acquire chronic electromyographic (EMG) recordings from leg muscles and to implant targeted spinal cord stimulation systems that remain stable up to several months after implantation in rats and nonhuman primates...
September 2018: Nature Protocols
M E Calvo, T Gunnarsson, L Smith, M Hao
OBJECTIVE: Delirium Tremens (DT) is the most severe complication of alcohol withdrawal syndrome (AWS), and has a mortality rate of 1-5%. Baclofen is recommended for spasticity treatment, but it has recently been used for alcohol withdrawal symptoms reduction and alcohol abstinence. CASE REPORT: A cervical spinal cord injury patient was treated for two years with oral baclofen 80 mg/day for spasticity. He is alcohol-dependent and a cannabis user and required an intrathecal baclofen (ITB) pump implant...
August 2018: European Review for Medical and Pharmacological Sciences
Nora Goebel, Ragi Nagib, Schahriar Salehi-Gilani, Samir Ahad, Marc Albert, Adrian Ursulescu, Ulrich F W Franke
Background: The extent of emergent surgery for acute DeBakey type I aortic dissection is discussed controversial. The frozen elephant trunk (FET) technique in addition to ascending and arch repair promotes aortic remodelling in the descending aorta and thus may provide superior long-term results in terms of less secondary re-interventions and reduced mortality linked to the downstream aorta. Methods: Between October 2009 and December 2016, a total of 72 patients underwent emergent hybrid aortic repair using the FET for acute DeBakey type I aortic dissection at our centre...
July 2018: Journal of Thoracic Disease
Haisong Yang, Yongfei Guo, Jiangang Shi, Jingchuan Sun, Yuan Wang, Ximing Xu, Bing Zheng, Guodong Shi
Posterior surgery has been widely used as an initial surgery for cervical ossification of the posterior longitudinal ligament (OPLL). However, some patients require revision surgery because of failure of symptom relief or late neurological deterioration after posterior surgery. The aim of this study is to retrospectively investigated the surgical results and complications of anterior controllable antedisplacement fusion (ACAF) as a revision surgical technique after initial posterior surgery for OPLL. The present study concluded 13 patients...
August 29, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hua Qin, Andong Zhao, Kui Ma, Xiaobing Fu
Transplantation of motor neurons can provide long-term functional benefits in animal models of neurodegenerative motor neuron diseases such as amyotrophic lateral sclerosis and traumatic spinal cord injury. Although embryonic stem cells can differentiate into motor neurons, alternative sources of motor neurons may be controllable for disease modeling and transplantation. Here, we show that human and mouse fibroblasts can be efficiently and directly converted into motor neurons by a cocktail of five small molecules, without the involvement of the neural progenitor stage...
August 27, 2018: Science China. Life Sciences
Qinfeng Wu, Qinghua Wang, Zhangjie Li, Xiangzhe Li, Jing Zang, Zhangwei Wang, Chen Xu, Yujia Gong, Jiaqi Cheng, Haoming Li, Guangyu Shen, Chuanming Dong
Spinal cord injury (SCI) is associated with a dismal prognosis including severe voluntary motor and sensory deficits in the presence of the current therapies, thus new and efficient treatment strategies are desperately required. Along with several advantages, such as easy accessibility, high-yield, potential of enormous proliferation, menstrual blood-derived mesenchymal stem cells (MenSCs) have been proposed as a promising strategy in regeneration medicine. In this study, the MenSCs were transplanted into incomplete thoracic (T10) spinal cord injury (SCI) rats, all rats were sacrificed at 7, 14, and 28 days after surgery...
August 29, 2018: Cell Death & Disease
Jeffrey D Redshaw, Sara M Lenherr, Sean P Elliott, John T Stoffel, Jeffrey P Rosenbluth, Angela P Presson, Jeremy B Myers
BACKGROUND: Neurogenic bladder (NGB) dysfunction after spinal cord injury (SCI) is generally irreversible. Preliminary animal and human studies have suggested that initiation of sacral neuromodulation (SNM) immediately following SCI can prevent neurogenic detrusor overactivity and preserve bladder capacity and compliance. We designed a multicenter randomized clinical trial to evaluate the effectiveness of early SNM after acute SCI. METHODS/DESIGN: The scientific protocol comprises a multi-site, randomized, non-blinded clinical trial...
August 29, 2018: BMC Urology
Damien D Pearse, Johana Bastidas, Sarah S Izabel, Mousumi Ghosh
The transplantation of Schwann cells (SCs) has been shown to provide tissue preservation and support axon growth and remyelination as well as improve functional recovery across a diverse range of experimental spinal cord injury (SCI) paradigms. The autologous use of SCs has progressed to Phase 1 SCI clinical trials in humans where their use has been shown to be both feasible and safe. The contribution of immune modulation to the protective and reparative actions of SCs within the injured spinal cord remains largely unknown...
August 28, 2018: International Journal of Molecular Sciences
Xiaoran Li, Caixia Fan, Zhifeng Xiao, Yannan Zhao, Haimin Zhang, Jie Sun, Yan Zhuang, Xianming Wu, Jiajia Shi, Yanyan Chen, Jianwu Dai
Neural stem cells (NSCs) show potential for spinal cord injury (SCI) repair. However, the current challenge is to direct their differentiation into neurons in the lesion site. It has been demonstrated that transplanted NSCs primarily differentiated into astrocytes rather than neurons due to the adverse microenvironment. It was reported that microtubule-stabilizing agent paclitaxel (PTX) was able to reduce scarring and enhance intrinsic axon regeneration after SCI. In this study, the effect of PTX on NSC differentiation was studied...
August 22, 2018: Biomaterials
F Heidemann, N Tsilimparis, F Rohlffs, E S Debus, A Larena-Avellaneda, S Wipper, T Kölbel
Background: Spinal cord ischemia with development of paraplegia is the most relevant complication of thoracoabdominal aortic surgery caused by compromising the segmental arteries. To prevent this devastating complication in endovascular aortic surgery, staging procedures have been developed to reinforce collateral blood flood to the spinal cord. Results: In patients with a medium to high risk for spinal cord ischemia, staged aortic repair is recommended. The classical staged repair is the two-step repair with delayed implantation of the aortic stent grafts...
2018: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
Weipeng Zheng, Fangtian Xu, Haoyi Chen, Ning Wang, Wende Xiao, YingJie Liang, Shifeng Wen
Background Diffusion tensor imaging (DTI) provides information about water molecule diffusion in spinal cord. Purpose This study was aimed to investigate DTI changes in the different stages of compressive spinal cord induced by water-absorbing material implantation. Material and Methods The spinal cord compression was administered over the fourth cervical vertebral level in rat. Rat models were divided into five subgroups according to compression stages: sham group, group A: three-day compression rat models; group B: 12-day compression rat models; group C: 20-day compression rat models; group D: 60-day compression rat models...
August 24, 2018: Acta Radiologica
Nagy Mekhail, Diana Mehanny, Sherif Armanyous, Youssef Saweris, Shrif Costandi
BACKGROUND CONTEXT: Chronic pain and obesity are both on the rise. Spinal cord stimulation has gained increasing popularity in the pain management field for the treatment of spine-related chronic pain, however to-date, the correlation between the spinal cord stimulator effectiveness and increasing body mass index (BMI) has not been fully established. PURPOSE: We aimed to investigate the correlation between patients' BMI and the percentage of pain relief as well as opioid utilization in chronic spine-related pain patients treated with spinal cord stimulation...
August 21, 2018: Spine Journal: Official Journal of the North American Spine Society
Alessia Giaquinta, Vincenzo Ardita, Ciro Ferrer, Clive B Beggs, Massimiliano Veroux, Matteo Barbante, Matteo Orrico, Piergiorgio Cao, Piefrancesco Veroux
PURPOSE: To assess early and midterm outcomes of iliac branch device (IBD) implantation without an aortic stent-graft for the treatment of isolated common iliac artery aneurysm (CIAA). METHODS: From December 2006 to June 2016, 49 isolated CIAAs in 46 patients were treated solely with an IBD at 7 vascular centers. Five patients were lost to follow-up, leaving 41 male patients (mean age 72.5±7.8 years) for analysis. Mean CIAA diameter was 39.1±10.5 mm (range 25-65)...
April 2018: Journal of Endovascular Therapy
Christoph Kühnle, Anton E Fürst, Elisabeth Ranninger, José Suárez Sánchez-Andrade, Jan M Kümmerle
OBJECTIVES:  It was recently shown that biomechanical stability achieved with a locking compression plate (LCP) for ventral cervical fusion in horses is similar to the commonly used Kerf cut cylinder. The advantages of the LCP system render it an interesting implant for this indication. The goal of this report was to describe surgical technique, complications and outcome of horses that underwent ventral fusion of two or three cervical vertebrae with an LCP. METHODS:  Medical records of eight horses were reviewed for patient data, history, preoperative grade of ataxia, diagnostic imaging, surgical technique and complications...
September 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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