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Spinal cord implants

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https://www.readbyqxmd.com/read/28535555/paresthesia-independence-an-assessment-of-technical-factors-related-to-10-khz-paresthesia-free-spinal-cord-stimulation
#1
Giuliano De Carolis, Mery Paroli, Lara Tollapi, Matthew W Doust, Abram H Burgher, Cong Yu, Thomas Yang, Donna M Morgan, Kasra Amirdelfan, Leonardo Kapural, B Todd Sitzman, Richard Bundschu, Ricardo Vallejo, Ramsin M Benyamin, Thomas L Yearwood, Bradford E Gliner, Ashley A Powell, Kerry Bradley
BACKGROUND: Spinal cord stimulation (SCS) has been successfully used to treat chronic intractable pain for over 40 years. Successful clinical application of SCS is presumed to be generally dependent on maximizing paresthesia-pain overlap; critical to achieving this is positioning of the stimulation field at the physiologic midline. Recently, the necessity of paresthesia for achieving effective relief in SCS has been challenged by the introduction of 10 kHz paresthesia-free stimulation...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#2
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28532908/the-safety-and-efficiency-of-pvcr-without-anterior-support-applied-in-treatment-of-yang-s-a-type-severe-thoracic-kyphoscoliosis
#3
Wen-Yuan Sui, Zi-Fang Huang, Yao-Long Deng, Heng-Wei Fan, Jing-Fan Yang, Fo-Bao Li, Jun-Lin Yang
OBJECT: To assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang's A type severe rigid thoracic kyphoscoliosis. METHODS: The records of 27 Yang's A type severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were retrospectively analyzed. Intraoperative multimodal neurophysiological monitoring (IONM) (6 modes: Somatosensory evoked potential (SSEP), Motor evoked potential (MEP), Descending neurogenic evoked potential (DNEP), Spinal cord evoked potential (SCEP), and Electromyography, both triggered and free run EMG) was conducted in all patients...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28527111/human-placenta-derived-mesenchymal-stem-cells-loaded-on-linear-ordered-collagen-scaffold-improves-functional-recovery-after-completely-transected-spinal-cord-injury-in-canine
#4
Sufang Han, Zhifeng Xiao, Xing Li, Huan Zhao, Bin Wang, Zhixue Qiu, Zhi Li, Xin Mei, Bai Xu, Caixia Fan, Bing Chen, Jin Han, Yanzheng Gu, Huilin Yang, Qin Shi, Jianwu Dai
Traumatic spinal cord injury (SCI) is a major challenge in the clinic. In this study, we sought to examine the synergistic effects of linear ordered collagen scaffold (LOCS) and human placenta-derived mesenchymal stem cells (hPMSCs) when transplanted into completely transected beagle dogs. After 36 weeks observation, we found that LOCS+hPMSCs implants promoted better hindlimb locomotor recovery than was observed in the non-treatment (control) group and LOCS group. Histological analysis showed that the regenerated tissue after treatment was well integrated with the host tissue, and dramatically reduced the volume of cystic and chondroitin sulfate proteoglycans (CSPGs) expression...
May 16, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28525663/management-of-male-and-female-neurogenic-stress-urinary-incontinence-in-spinal-cord-injured-sci-patients-using-adjustable-continence-therapy
#5
Enrico Ammirati, Alberto Manassero, Alessandro Giammò, Roberto Carone
INTRODUCTION: Artificial urinary sphincter (AUS) is an option for the treatment of neurogenic stress urinary incontinence (nSUI), but complications and re-operation rates are high, and there is no clear indication from guidelines (1). The aim of our study is to evaluate the effectiveness of a less invasive continence device in neurogenic population: Adjustable Continence Therapy ProACT/ACT®. METHODS: We retrospectively includedpatients with spinal cord injuries in this study, complaining of nSUI and treated at our Institution with Pro-ACT/ACT® implantation...
May 16, 2017: Urologia
https://www.readbyqxmd.com/read/28525553/evaluation-of-conventional-and-frozen-elephant-trunk-techniques-on-spinal-cord-blood-flow-in-an-animal-model%C3%A2
#6
Sergey Leontyev, Maja-Theresa Dieterlen, Michelle Halling, Franziska Schlegel, Alexandro Hoyer, Susann Ossmann, Kerstin Klaeske, Christian D Etz, Friedrich W Mohr
OBJECTIVES: The treatment of patients with extensive thoracic aortic disease involving the arch and descending aorta is often performed using the frozen elephant trunk technique (FET). Spinal cord blood flow (SCBF) in cervical, thoracic and lumbar sections prior, during and after aortic arch surgery were compared in conventional elephant trunk (cET) and FET technique in a pig model. METHODS: German Landrace pigs (75-85 kg) underwent aortic arch surgery using the FET ( n  = 8) or cET ( n  = 8) techniques...
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28503328/phrenic-pacing-compared-with-mechanical-ventilation
#7
Morten Packert Andersen, Michael Laub, Fin Biering-Sørensen
STUDY DESIGN: Comparable case series. OBJECTIVES: High-cervical spinal cord injury (SCI) may disrupt the ability to breathe sufficiently. To restore respiration a phrenic nerve pacer can be implanted. The aims of this study were to describe the use of phrenic nerve pacing in tetraplegics in Denmark and compare the users with a population of ventilator dependent tetraplegics. SETTING: Clinics for Spinal Cord Injuries, and Respiratory Centre East, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28500623/simultaneous-inhibition-of-nmda-and-mglu1-5-receptors-by-levo-corydalmine-in-rat-spinal-cord-attenuates-bone-cancer-pain
#8
Wen-Ling Dai, Bing Yan, Nan Jiang, Juan-Juan Wu, Xiu-Feng Liu, Ji-Hua Liu, Bo-Yang Yu
Bone cancer pain is a challenge for its not completely clarified mechanism and broad clinical morbidity. Therefore, novel and more effective drugs are urgent needed for improvement of patients' quality of life. Glutamate receptors have been associated with the development of the central sensitization of chronic pain. Inhibition of N-methyl-D-aspartate (NMDA) and metabotropic glutamate (mGlu) receptors can effectively attenuate bone cancer pain respectively. Herein, our results indicated that levo-Corydalmine (l-CDL), a compound from Corydalis yanhusuo W...
May 13, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28493599/spinal-cord-stimulator-implant-infection-rates-and-risk-factors-a-multicenter-retrospective-study
#9
Bryan C Hoelzer, Mark A Bendel, Timothy R Deer, Jason S Eldrige, David R Walega, Zhen Wang, Shrif Costandi, Gerges Azer, Wenchun Qu, Steven M Falowski, Stephanie A Neuman, Susan M Moeschler, Catherine Wassef, Christopher Kim, Tariq Niazi, Taher Saifullah, Brian Yee, Chong Kim, Christine L Oryhan, Joshua M Rosenow, Daniel T Warren, Imanuel Lerman, Ruben Mora, Salim M Hayek, Michael Hanes, Thomas Simopoulos, Sanjiv Sharma, Chris Gilligan, Warren Grace, Timothy Ade, Nagy A Mekhail, John P Hunter, Daniel Choi, Deborah Y Choi
OBJECTIVES: Spinal cord stimulation is an evidence-based treatment for a number of chronic pain conditions. While this therapy offers improvement in pain and function it is not without potential complications. These complications include device failure, migration, loss of therapeutic paresthesia, and infection. This article looked to establish a modern infection rate for spinal cord stimulators, assess the impact of known risk factors for surgical site infections and to determine the impact of certain preventative measures on the rate of infection...
May 11, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28489550/a-fully-integrated-wireless-soc-for-motor-function-recovery-after-spinal-cord-injury
#10
Yi-Kai Lo, Yen-Cheng Kuan, Stanislav Culaclii, Brian Kim, Po-Min Wang, Chih-Wei Chang, Jonathan A Massachi, Minji Zhu, Kuanfu Chen, Parag Gad, V Reggie Edgerton, Wentai Liu
This paper presents a wirelessly powered, fully integrated system-on-a-chip (SoC) supporting 160-channel stimulation, 16-channel recording, and 48-channel bio-impedance characterization to enable partial motor function recovery through epidural spinal cord electrical stimulation. A wireless transceiver is designed to support quasi full-duplex data telemetry at a data rate of 2 Mb/s. Furthermore, a unique in situ bio-impedance characterization scheme based on time-domain analysis is implemented to derive the Randles cell electrode model of the electrode-electrolyte interface...
May 5, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#11
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28482124/collagen-scaffold-combined-with-human-umbilical-cord-derived-mesenchymal-stem-cells-promote-functional-recovery-after-scar-resection-in-rats-with-chronic-spinal-cord-injury
#12
Nuo Wang, Zhifeng Xiao, Yannan Zhao, Bin Wang, Xing Li, Jing Li, Jianwu Dai
Effective therapeutic strategies for treating chronic spinal cord injury (SCI) are currently unavailable. Scar tissue in the lesion area is a main inhibitory factor for axonal regeneration and repair of chronic SCI. In this study, scar tissue was surgically resected from adult rats with 12-week chronic SCI, and then collagen scaffold (named NeuroRegen Scaffold [NRS]) and human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) were implanted into the resected cavity to repair chronic SCI. The results demonstrated that the locomotor function of rats was not affected by surgical scar resection, indicating its safety in treating chronic SCI...
May 8, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28479302/comprehensive-monosynaptic-rabies-virus-mapping-of-host-connectivity-with-neural-progenitor-grafts-after-spinal-cord-injury
#13
Andrew F Adler, Corinne Lee-Kubli, Hiromi Kumamaru, Ken Kadoya, Mark H Tuszynski
Neural progenitor cells grafted to sites of spinal cord injury have supported electrophysiological and functional recovery in several studies. Mechanisms associated with graft-related improvements in outcome appear dependent on functional synaptic integration of graft and host systems, although the extent and diversity of synaptic integration of grafts with hosts are unknown. Using transgenic mouse spinal neural progenitor cell grafts expressing the TVA and G-protein components of the modified rabies virus system, we initiated monosynaptic tracing strictly from graft neurons placed in sites of cervical spinal cord injury...
May 3, 2017: Stem Cell Reports
https://www.readbyqxmd.com/read/28478920/intravenous-infusion-of-adipose-derived-stem-stromal-cells-improves-functional-recovery-of-rats-with-spinal-cord-injury
#14
Yuki Ohta, Akemi Hamaguchi, Masanori Ootaki, Minoru Watanabe, Yuko Takeba, Taroh Iiri, Naoki Matsumoto, Mitsuko Takenaga
BACKGROUND AIMS: Adipose tissue has therapeutic potential for spinal cord injury (SCI) because it contains multipotent cells known as adipose-derived stem/stromal cells (ASCs). In this study, we attempted intravenous ASC transplantation in rats with SCI to examine the effect on functional recovery. METHODS: ASCs (2.5 × 10(6)) were intravenously infused into SCI rats, after which hindlimb motor function was evaluated. Distribution of transplanted ASCs was investigated and growth factor/cytokine levels were determined...
May 3, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28474539/induced-neural-activity-promotes-an-oligodendroglia-regenerative-response-in-the-injured-spinal-cord-and-improves-motor-function-after-spinal-cord-injury
#15
Qun Li, Thierry Houdayer, Su Liu, Visar Belegu
Myelination in central nervous system (CNS) is a dynamic process that includes birth of oligodendrocyte progenitor cells (OPCs), their differentiation into oligodendrocytes, and ensheathment of axons. Regulation of myelination by neuronal activity has emerged as a new mechanism of CNS plasticity. Indeed, activity-dependent myelination has been shown to regulate sensory, motor and cognitive functions. In this work, we aimed to employ this mechanism of CNS plasticity by utilizing induced neuronal activity to promote remyelination and functional recovery in a subchronic model of SCI...
May 5, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28464747/cone-beam-ct-based-set-up-strategies-with-and-without-rotational-correction-for-stereotactic-body-radiation-therapy-in-the-liver
#16
Jenny Bertholet, Esben Worm, Morten Høyer, Per Poulsen
BACKGROUND: Accurate patient positioning is crucial in stereotactic body radiation therapy (SBRT) due to a high dose regimen. Cone-beam computed tomography (CBCT) is often used for patient positioning based on radio-opaque markers. We compared six CBCT-based set-up strategies with or without rotational correction. MATERIAL AND METHODS: Twenty-nine patients with three implanted markers received 3-6 fraction liver SBRT. The markers were delineated on the mid-ventilation phase of a 4D-planning-CT...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28459781/best-practices-in-spinal-cord-stimulation
#17
B Todd Sitzman, David Provenzano
STUDY DESIGN: A review of clinical best practices for spinal cord stimulation (SCS). OBJECTIVE: To summarize expert opinion with regards to utilizing SCS, including patient selection, disease indication, operative management and SCS device selection. Additional focus on providing quality care to individual patients while acknowledging the importance of durable outcomes and care delivery costs. SUMMARY OF BACKGROUND DATA: For more than 30 years, SCS has successfully alleviated patient suffering and enhanced the lives of patients with refractory pain conditions...
April 28, 2017: Spine
https://www.readbyqxmd.com/read/28452616/an-ovine-model-of-cerebral-catheter-venography-for-implantation-of-an-endovascular-neural-interface
#18
Thomas James Oxley, Nicholas Lachlan Opie, Gil Simon Rind, Kishan Liyanage, Sam Emmanuel John, Stephen Ronayne, Alan James McDonald, Anthony Dornom, Timothy John Haynes Lovell, Peter John Mitchell, Iwan Bennett, Sebastien Bauquier, Leon Norris Warne, Chris Steward, David Bruce Grayden, Patricia Desmond, Stephen M Davis, Terence John O'Brien, Clive N May
OBJECTIVE Neural interface technology may enable the development of novel therapies to treat neurological conditions, including motor prostheses for spinal cord injury. Intracranial neural interfaces currently require a craniotomy to achieve implantation and may result in chronic tissue inflammation. Novel approaches are required that achieve less invasive implantation methods while maintaining high spatial resolution. An endovascular stent electrode array avoids direct brain trauma and is able to record electrocorticography in local cortical tissue from within the venous vasculature...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28444817/microtubule-stabilization-promoted-axonal-regeneration-and-functional-recovery-after-spinal-root-avulsion
#19
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
#20
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
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