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Spinal cord implants

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https://www.readbyqxmd.com/read/28444817/microtubule-stabilization-promoted-axonal-regeneration-and-functional-recovery-after-spinal-root-avulsion
#1
Heng Li, Wutian Wu
A spinal root avulsion injury disconnects spinal roots with the spinal cord. The rampant motoneuron death, inhibitory CNS/PNS transitional zone (TZ) for axonal regrowth and limited regeneration speed together lead to motor dysfunction. Microtubules rearrange to assemble a new growth cone and disorganized microtubules underline regeneration failure. It's been shown that microtubule-stabilizing drug, Epothilone B, enhanced axonal regeneration and attenuated fibrotic scaring after spinal cord injury. Here, we are reporting that after spinal root avulsion+ re-implantation in adult rats, EpoB treatment improved motor functional recovery and potentiated electrical responses of motor units...
April 26, 2017: European Journal of Neuroscience
https://www.readbyqxmd.com/read/28443786/characterization-of-volitional-electromyographic-signals-in-the-lower-extremity-after-motor-complete-spinal-cord-injury
#2
Elizabeth Heald, Ronald Hart, Kevin Kilgore, P Hunter Peckham
BACKGROUND: Previous studies have demonstrated the presence of intact axons across a spinal cord lesion, even in those clinically diagnosed with complete spinal cord injury (SCI). These axons may allow volitional motor signals to be transmitted through the injury, even in the absence of visible muscle contraction. OBJECTIVE: To demonstrate the presence of volitional electromyographic (EMG) activity below the lesion in motor complete SCI and to characterize this activity to determine its value for potential use as a neuroprosthetic command source...
April 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/28415681/a-reproducible-model-of-intramedullary-spinal-cord-tumor-in-rats-bearing-rg2-cells
#3
Yuandong Zhuang, Wei Zhao, Weiqiang Zhang, Hao Wei, Xinming Huang, Gangfeng Cai, Chaofeng Fu, Chunhua Wang, Rui Wang, Songsheng Shi, Weizhong Yang, Chunmei Chen
Intramedullary spinal cord tumors (IMSCTs) are lethal diseases to many patients. The lack of adequate animal model has hampered the development of novel treatments. In the current study, a rodent intramedullary glioma model is established to study IMSCT progression. Fischer 344 rats received a intramedullary implantation of RG2 glioma cells. The neurological state of each rat was evaluated on daily basis using the Basso, Beattie and Bresnahan (BBB) scale. Rats implanted with RG2 cells developed significant hind limb paraplegia 20 days after implantation...
March 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414769/creation-of-an-intramedullary-cavity-by-hemorrhagic-necrosis-removal-24-h-after-spinal-cord-contusion-in-rats-for-eventual-intralesional-implantation-of-restorative-materials
#4
Gabriel Guizar-Sahagun, Angelina Martinez-Cruz, Rebecca E Franco-Bourland, Eduardo Cruz-GarcĂ­a, Alvaro Corona-Juarez, Araceli Diaz-Ruiz, Israel Grijalva, Horacio J Reyes-Alva, Ignacio Madrazo
Intramedullary hemorrhagic necrosis occurs early after spinal cord injury at the site of injury and adjacent segments. It is considered harmful because of its potential to aggravate secondary injury, and to interfere with axonal regeneration; it might also lead to an unfavorable environment for intralesional implants. Removal of hemorrhagic necrosis has been attempted before with variable results. The invasive nature of these procedures carries the risk of exacerbating damage to the injured cord. The overall objective for this study was to test several strategies for non-damaging removal of hemorrhagic necrosis and characterize the resulting cavity looking for a space for future intralesional therapeutic implants in rats with acute cord injury...
2017: PloS One
https://www.readbyqxmd.com/read/28406070/an-investigation-of-the-relationship-between-autonomic-dysreflexia-and-intrathecal-baclofen-in-patients-with-spinal-cord-injury
#5
Anna Sophia Del Fabro, Melvin Mejia, Gregory Nemunaitis
OBJECTIVE: To study the relationship between autonomic dysreflexia and intrathecal baclofen in patients with spinal cord injury. DESIGN: Retrospective chart review. SETTING: Inpatient and outpatient acute rehabilitation facility. PARTICIPANTS: Thirty-four subjects. INTERVENTIONS: We reviewed patients' medical records to ascertain the presence of symptomatic autonomic dysreflexia (AD) prior to and after implantation of an intrathecal baclofen (ITB) pump for spasticity in spinal cord injury patients...
April 13, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28399549/cost-effectiveness-data-regarding-spinal-cord-stimulation-for-low-back-pain
#6
Christian Hoelscher, Jonathan Riley, Chengyuan Wu, Ashwini Sharan
STUDY DESIGN: Review of published literature pertaining to spinal cord stimulation cost data analysis. OBJECTIVE: To acquire, organize, and succinctly summarize the available literature regarding the costs associated with, and the cost-effectiveness of, spinal cord stimulation. SUMMARY OF BACKGROUND DATA: Chronic back and limb pain is a pervasive complaint in modern society, with estimated annual costs of medical care greater than $100 billion...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28395417/-dosimetry-verification-of-radioactive-seed-implantation-with-3d-printing-template-and-ct-guidance-for-paravertebral-retroperitoneal-malignant-tumor
#7
Z Ji, Y L Jiang, F X Guo, R Peng, H T Sun, J H Fan, J J Wang
Objective: To compare the dose distributions of postoperative plans with preoperative plans for seeds implantations of paravertebral/retroperitoneal tumors assisted by 3D printing guide template and CT guidance, explore the effects of the technology for seeds implantations in dosimetry level and provide data support for the optimization and standardization in seeds implantation. Methods: Between December 2015 and July 2016, a total of 10 patients with paravertebral/retroperitoneal tumors (12 lesions) received 3D printing template assist radioactive seeds implantations in department of radiation oncology of Peking University Third Hospital, and included in the study...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28392569/multichannel-polymer-scaffold-seeded-with-activated-schwann-cells-and-bone-mesenchymal-stem-cells-improves-axonal-regeneration-and-functional-recovery-after-rat-spinal-cord-injury
#8
Er-Zhu Yang, Guo-Wang Zhang, Jian-Guang Xu, Shuai Chen, Hua Wang, Liang-Liang Cao, Bo Liang, Xiao-Feng Lian
The adult mammalian CNS has a limited capacity to regenerate after traumatic injury. In this study, a combinatorial strategy to promote axonal regeneration and functional recovery after spinal cord injury (SCI) was evaluated in adult rats. The rats were subjected to a complete transection in the thoracic spinal cord, and multichannel scaffolds seeded with activated Schwann cells (ASCs) and/or rat bone marrow-derived mesenchymal stem cells (MSCs) were acutely grafted into the 3-mm-wide transection gap. At 4 weeks post-transplantation and thereafter, the rats receiving scaffolds seeded with ASCs and MSCs exhibited significant recovery of nerve function as shown by the Basso, Beattie and Bresnahan (BBB) score and electrophysiological test results...
April 10, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28388831/estrogen-signaling-is-necessary-for-exercise-mediated-enhancement-of-motoneuron-participation-in-axon-regeneration-after-peripheral-nerve-injury-in-mice
#9
Melina C Acosta, Patricia A Copley, Jamie R Harrell, Jennifer C Wilhelm
Thousands of people each year suffer from peripheral nerve injury. Treatment options are limited, and recovery is often incomplete. Treadmill exercise can enhance nerve regeneration; however, this appears to occur in a sex-dependent manner. Females respond best to short duration, high speed interval training; whereas, males respond best to slower, continuous training. Previous studies have shown a role for testosterone in this process, but the role of estrogen is unknown. To evaluate the role of estrogen signaling in treadmill exercise, we blocked estrogen receptor (ER) signaling during treadmill exercise in males and female wild type mice...
April 7, 2017: Developmental Neurobiology
https://www.readbyqxmd.com/read/28387623/flow-diverter-devices-in-ruptured-intracranial-aneurysms-a-single-center-experience
#10
Emilio Lozupone, Mariangela Piano, Luca Valvassori, Luca Quilici, Guglielmo Pero, Emiliano Visconti, Edoardo Boccardi
OBJECTIVE In this single-center series, the authors retrospectively evaluated the effectiveness, safety, and midterm follow-up results of ruptured aneurysms treated by implantation of a flow diverter device (FDD). METHODS The records of 17 patients (12 females, 5 males, average World Federation of Neurosurgical Societies score = 2.9) who presented with subarachnoid hemorrhage (SAH) due to the rupture of an intracranial aneurysm treated with an FDD were retrospectively reviewed. Of 17 ruptured aneurysms, 8 were blood blister-like aneurysms and the remaining 9 were dissecting aneurysms...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28370989/specialty-based-variations-in-spinal-cord-stimulation-success-rates-for-treatment-of-chronic-pain
#11
Syed Mohammed Qasim Hussaini, Kelly Ryan Murphy, Jing L Han, Aladine A Elsamadicy, Siyun Yang, Alykhan Premji, Beth Parente, Jichun Xie, Promila Pagadala, Shivanand P Lad
OBJECTIVES: Spinal cord stimulation (SCS) has emerged as an appropriate modality of treatment for intractable chronic pain. The present study examines variations in SCS trial-to-permanent conversion rates based on provider types performing the procedure. MATERIALS AND METHODS: We designed a large, retrospective analysis using the Truven MarketScan data base analyzing adult SCS patients with provider information available, with or without IPG implantation from the years 2007-2012...
April 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28370852/prospective-study-of-the-use-of-intraoperative-neuromonitoring-in-determining-post-operative-energy-requirements-and-physiologic-midline-in-spinal-cord-stimulation
#12
Claire Collison, Julia Prusik, Steven Paniccioli, Michael Briotte, Rachael Grey, Paul Feustel, Julie G Pilitsis
BACKGROUND: Intraoperative neuromonitoring (IONM) through electromyography (EMG) studies has been shown to be a safe, effective way to determine the laterality of the spinal cord and guide electrode placement during spinal cord stimulation (SCS). However, the use of IONM to predict post-operative energy requirements and midline has not been examined and offers a new avenue to streamline programming and device selection. Further, the impact of cerebrospinal fluid (CSF) thickness on intraoperative and post-operative amplitudes is understood but has not been explicitly characterized...
March 28, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28370802/spinal-cord-stimulation-for-spasticity-historical-approaches-current-status-and-future-directions
#13
REVIEW
Sean J Nagel, Saul Wilson, Michael D Johnson, Andre Machado, Leonardo Frizon, Matthieu K Chardon, Chandan G Reddy, George T Gillies, Matthew A Howard
INTRODUCTION: Millions of people worldwide suffer with spasticity related to irreversible damage to the brain or spinal cord. Typical antecedent events include stroke, traumatic brain injury, and spinal cord injury, although insidious onset is also common. Regardless of the cause, the resulting spasticity leads to years of disability and reduced quality of life. Many treatments are available to manage spasticity; yet each is fraught with drawbacks including incomplete response, high cost, limited duration, dose-limiting side effects, and periodic maintenance...
April 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28370724/clinical-paresthesia-atlas-illustrates-likelihood-of-coverage-based-on-spinal-cord-stimulator-electrode-location
#14
Alexander Taghva, Edward Karst, Paul Underwood
OBJECTIVE: Concordant paresthesia coverage is an independent predictor of pain relief following spinal cord stimulation (SCS). Using aggregate data, our objective is to produce a map of paresthesia coverage as a function of electrode location in SCS. METHODS: This retrospective analysis used x-rays, SCS programming data, and paresthesia coverage maps from the EMPOWER registry of SCS implants for chronic neuropathic pain. Spinal level of dorsal column stimulation was determined by x-ray adjudication and active cathodes in patient programs...
March 28, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28363483/restoration-of-reaching-and-grasping-movements-through-brain-controlled-muscle-stimulation-in-a-person-with-tetraplegia-a-proof-of-concept-demonstration
#15
A Bolu Ajiboye, Francis R Willett, Daniel R Young, William D Memberg, Brian A Murphy, Jonathan P Miller, Benjamin L Walter, Jennifer A Sweet, Harry A Hoyen, Michael W Keith, P Hunter Peckham, John D Simeral, John P Donoghue, Leigh R Hochberg, Robert F Kirsch
BACKGROUND: People with chronic tetraplegia, due to high-cervical spinal cord injury, can regain limb movements through coordinated electrical stimulation of peripheral muscles and nerves, known as functional electrical stimulation (FES). Users typically command FES systems through other preserved, but unrelated and limited in number, volitional movements (eg, facial muscle activity, head movements, shoulder shrugs). We report the findings of an individual with traumatic high-cervical spinal cord injury who coordinated reaching and grasping movements using his own paralysed arm and hand, reanimated through implanted FES, and commanded using his own cortical signals through an intracortical brain-computer interface (iBCI)...
March 28, 2017: Lancet
https://www.readbyqxmd.com/read/28353527/baclofen-pumps-uses-and-complications
#16
Seth M Woolf, Carl R Baum
Intrathecal baclofen therapy, given via an implanted pump in the abdominal wall either as a continuous infusion or bolus dosing, has been used for more than 25 years to treat the spasticity and dystonia associated with various brain and spinal cord conditions. Pediatric clinicians occasionally encounter baclofen pumps, and in the pediatric setting, significant morbidity can arise from their use. This article presents the background, mechanism of action, uses, and complications of intrathecal baclofen therapy and discusses various management strategies should complications occur...
April 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#17
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28346006/magnetic-resonance-imaging-susceptibility-artifacts-in-the-cervical-vertebrae-and-spinal-cord-related-to-monocortical-screw-polymethylmethacrylate-implants-in-canine-cadavers
#18
Brian G Jones, Geoffrey T Fosgate, Eric M Green, Amy M Habing, Bianca F Hettlich
OBJECTIVE To characterize and compare MRI susceptibility artifacts related to titanium and stainless steel monocortical screws in the cervical vertebrae and spinal cord of canine cadavers. SAMPLE 12 canine cadavers. PROCEDURES Cervical vertebrae (C4 and C5) were surgically stabilized with titanium or stainless steel monocortical screws and polymethylmethacrylate. Routine T1-weighted, T2-weighted, and short tau inversion recovery sequences were performed at 3.0 T. Magnetic susceptibility artifacts in 20 regions of interest (ROIs) across 4 contiguous vertebrae (C3 through C6) were scored by use of an established scoring system...
April 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28339448/efficacious-dorsal-root-ganglion-stimulation-for-painful-small-fiber-neuropathy-a-case-report
#19
Paolo Maino, Eva Koetsier, Alain Kaelin-Lang, Claudio Gobbi, Roberto Perez
Small fiber neuropathy is a disorder of the peripheral nerves with typical symptoms of burning, sharp, and shooting pain and sensory disturbances in the feet. Pain treatment depends principally on the underlying etiology with concurrent administration of antidepressants, anticonvulsants, opioids, and topical treatments like capsaicin and local anesthetics. However, treatments for pain relief in these patients frequently fail. We describe the first case of intractable painful small fiber neuropathy of the foot successfully treated with spinal cord stimulation of the left L5 dorsal root ganglion...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337820/selective-radiofrequency-stimulation-of-the-dorsal-root-ganglion-drg-as-a-method-for-predicting-targets-for-neuromodulation-in-patients-with-post-amputation-pain-a-case-series
#20
Corey W Hunter, Ajax Yang, Tim Davis
OBJECTIVE: While spinal cord stimulation (SCS) has established itself as an accepted and validated treatment for neuropathic pain, there are a number of conditions where it has experienced less, long-term success: post amputee pain (PAP) being one of them. Dorsal root ganglion (DRG) stimulation has shown great promise, particularly in conditions where traditional SCS has fallen short. One major difference between DRG stimulation and traditional SCS is the ability to provide focal stimulation over targeted areas...
March 23, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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