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Spinal cord implants

Elias Shaaya, Jared Fridley, Sean M Barber, Sohail Syed, Jimmy Xia, Michael Galgano, Adetokunbo Oyelese, Albert Telfeian, Ziya Gokaslan
BACKGROUND: Cervical spine metastases with circumferential spinal cord compression are often treated with combined anterior-posterior decompression and stabilization. In patients with large anterior neck masses, prior radiotherapy to the neck, or prior anterior neck surgery, however, anterior approaches may pose additional risk. In such cases, posterior-only approaches that allow for circumferential decompression and anterior column reconstruction may be beneficial. CASE DESCRIPTION: We present the case of a seventy-year-old male with follicular thyroid carcinoma metastatic to the cervical spine causing spinal cord compression...
November 14, 2018: World Neurosurgery
Sam Eldabe, Ashish Gulve, Simon Thomson, Ganesan Baranidharan, Rui Duarte, Susan Jowett, Harbinder Sandhu, Raymond Chadwick, Morag Brookes, Anisah Tariq, Jenny Earle, Jill Bell, Anu Kansal, Shelley Rhodes, Rod S Taylor
BACKGROUND: The TRIAL-STIM Study aims to assess the diagnostic performance, clinical outcomes and cost-effectiveness of a screening trial prior to full implantation of a spinal cord stimulation (SCS) device. METHODS/DESIGN: The TRIAL-STIM Study is a superiority, parallel-group, three-centre, randomised controlled trial in patients with chronic neuropathic pain with a nested qualitative study and economic evaluation. The study will take place in three UK centres: South Tees Hospitals NHS Foundation Trust (The James Cook University Hospital); Basildon and Thurrock University Hospitals NHS Foundation Trust; and Leeds Teaching Hospitals NHS Trust...
November 16, 2018: Trials
Roy Hwang, Nicholas Field, Vignessh Kumar, Steven Paniccioli, Rachel Grey, Michael Briotte, Vishad Sukul, Julie G Pilitsis
INTRODUCTION: Placement of spinal cord stimulation (SCS) paddles under general anesthesia using intraoperative neuromonitoring (IONM) has been shown to be associated with equivocal or superior clinical outcomes in comparative studies. The value of IONM in percutaneous permanent SCS placement has not been demonstrated. METHODS: Outcomes for patients under percutaneous SCS placement performed with IONM were prospectively collected. Descriptive outcomes included numerical rating scale (NRS), the Oswestry disability index (ODI), McGill pain questionnaire, pain catastrophizing scale score (PCS), and Beck Depression Inventory...
November 16, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Philip Finch, Leanne Price, Peter Drummond
OBJECTIVES: The study objectives were to perform a clinical audit of patients implanted with 10 kHz spinal cord (SCS) and peripheral nerve (PNS) stimulators for treating chronic pain and to investigate the effect of 10 kHz PNS on pain and other sensory modalities in a double-blind cross-over trial. METHODS: Pain, disability, and medication status were audited for 12 months after stimulator implantation in 58 SCS patients and in 11 PNS patients with an electrode positioned along a branch of the occipital or trigeminal nerve (four patients), a limb nerve trunk (four patients), or the S1 nerve root, genito-femoral nerve or ileo-inguinal nerve (one patient each)...
November 16, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Jonathan Massachi, Yi-Kai Lo, Po-Min Wang, Wentai Liu
The efficacy of many clinical applications of electrical stimulation is currently gauged only by patients' verbal feedback or through the use of an independent system, limiting physicians' ability to provide quality treatment. By integrating neural response recording into the system, though, more accurate measures of treatment effectiveness are possible. This paper presents a platform which enables wireless control of an implantable bioelectronic device which integrates functional electrical stimulation and simultaneous recording of neural activity for a wide range of potential applications including motor function prostheses for spinal cord injury, retinal prostheses, and treatments for various other conditions...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Esma Cetinkaya, Sinan Gok, Mesut Sahin
Development of micro electrode arrays for neural recording is an active field that thrives on novel materials and fabrication techniques offered by micro fabrication technology. The material and mechanical properties of microelectrode arrays have a critical role on the quality and longevity of neural signals. In this study, carbon fiber microelectrode (CFME) bundles were developed and implanted in the spinal cord of experimental animals for textbf{\textit{in vivo{recording. Neural data analysis revealed that single spikes could successfully be recorded and sorted...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Dolllaporn Anopas, Lin Junquan, Ulla Milbreta, Vincent Po Hen Lin, Jiah Shin Chin, Seng Kwee Wee, Tow Peh Er, Sing Yian Chew, Wei Tech Ang
Spinal cord injury (SCI) is a traumatic event which leads to the loss of sensory and motor functions of the body. Complete recovery of these functions are usually limited due to the inability of the damaged axons within the central nervous system (CNS) to regenerate autonomously. Here, a combinatorial regenerative and rehabilitative approach to regrow damaged axons was proposed. Sprague-Dawley rats were subjected to a severe T9-T10 full tranection injury with a 2mm gap. Neurotrophin-3 (NT-3) loaded fibrous scaffold was implanted within the gap to provide topographical guidance for the axons to cross the injured region...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Tracie Tran, Po T Wang, Brian Lee, Charles Y Liu, Evgeniy I Kreydin, Zoran Nenadic, An H Do
Current therapies for neurogenic bladder do not allow spinal cord injury patients to regain conscious control of urine storage or voiding. Novel neural technologies may provide means to improve or restore the connection between the brain and the bladder; however, the specific brain areas and their underlying neural activities responsible for micturition must be better understood in order to design such technologies. In this retrospective study, we analyzed electrocorticographic (ECoG) data obtained from epilepsy patients who underwent ECoG grid implantation for epilepsy surgery evaluation, in the hopes of determining specific electrophysiological activity associated with micturition...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
G Gerboni, S E John, S M Ronayne, G S Rind, C N May, T J Oxley, D B Grayden, N L Opie, Y T Wong
Electrical stimulation of neural tissue and recording of neural activity are the bases of emerging prostheses and treatments for spinal cord injury, stroke, sensory deficits, and drug-resistant neurological disorders. Safety and efficacy are key aspects for the clinical acceptance of therapeutic neural stimulators. The cortical vasculature has been shown to be a safe site for implantation of electrodes for chronically recording neural activity, requiring no craniotomy to access high-bandwidth, intracranial EEG...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Gudrun Erla Olafsdottir, Wouter A Serdijn, Vasiliki Giagka
This paper presents the design and fabrication of an implantable control unit intended for epidural spinal cord stimulation (ESCS) in rats. The device offers full programmability over stimulation parameters and delivers a constant current to an electrode array to be located within the spinal canal. It implements an adaptive voltage compliance in order to reduce the unnecessary power dissipation often experienced in current-controlled stimulation (CCS) devices. The compliance is provided by an adjustable boost converter that offers a voltage output in the range of 6...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Xiaoyi Min, Shiloh Sison
There is a risk for patients with spinal cord stimulation (SCS) implants that MRI-RF induced heating may cause harm to spinal cord (SC) or spinal nerves. The ISO/TS 10974 Clause 8, Tier 3 based evaluation of RF heating has been commonly used for active implantable manufactures through regulatory body world-wide. Generating TFs for the lead and SCS system is an essential component in Tier 3. The objective of this paper is to investigate the effects of media on transfer functions (TFs) and dissipated power near the distal electrode along clinical pathways of SCS implants...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Giuseppe Schiavone, Fabien Wagner, Florian Fallegger, Xiaoyang Kang, Nicolas Vachicouras, Beatrice Barra, Marco Capogrosso, Jocelyne Bloch, Gregoire Courtine, Stephanie P Lacour
Long-term biointegration of man-made neural interfaces is influenced by the mechanical properties of the implant materials. Substantial experimental work currently aims at replacing conventional hard implant materials with soft alternatives that can favour a lower immune response. Here we assess the performance of a soft electrode array implanted in the spinal epidural space of a minipig model for a period of 6 months. The electrode array includes platinum-silicone electrode contacts and elastic thin-film gold interconnects embedded in silicone...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Beatrice Barra, Camille Roux, Melanie Kaeser, Giuseppe Schiavone, Stephanie P Lacour, Jocelyne Bloch, Gregoire Courtine, Eric M Rouiller, Eric Schmidlin, Marco Capogrosso
Recovery of reaching and grasping ability is the priority for people with cervical spinal cord injury (SCI). Epidural electrical stimulation (EES) has shown promising results in improving motor control after SCI in various animal models and in humans. Notably, the application of stimulation bursts with spatiotemporal sequences that reproduce the natural activation of motoneurons restored skilled leg movements in rodent and nonhuman primate models of SCI. Here, we studied whether this conceptual framework could be transferred to the design of cervical EES protocols for the recovery of reaching and grasping in nonhuman primates...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Jonathan Scott Calvert, Peter Grahn, Jeffrey Strommen, Igor Lavrov, Lisa Beck, Megan Gill, Margaux Linde, Desmond Brown, Meegan van Straaten, Daniel Veith, Cesar Lopez, Dimitry Sayenko, Yury Gerasimenko, Victor Reggie Edgerton, Kristin Zhao, Kendall Lee
Epidural electrical stimulation (EES) of the spinal cord has been shown to restore function after spinal cord injury (SCI). Characterization of EES-evoked motor responses has provided a basic understanding of spinal sensorimotor network activity related to EES-enabled motor activity of the lower extremities. However, the use of EES-evoked motor responses to guide EES system implantation over the spinal cord and their relation to post-operative EES-enabled function in humans with chronic paralysis due to SCI has yet to be described...
November 15, 2018: Journal of Neurotrauma
Spyridon Skoufias, Mikaël Sturny, Rodrigo Fraga-Silva, Theodore G Papaioannou, Nikolaos Stergiopoulos, Ioannis Adamakis, Constantinos A Constantinides
INTRODUCTION: Many studies have shown that electrostimulation of the cavernosal nerve can induce and maintain penile erection. Based on these discoveries, neurostimulation to activate the erectile response has been considered a potential solution to treat erectile dysfunction (ED). However, despite recognized potential, this technology has not been further developed. The barrier is the complex anatomy of the human cavernous nerve, which challenges the intraoperative identification of the cavernosal nerves for electrode placement...
November 2018: Journal of Sexual Medicine
Christopher Kurz, Philipp Süss, Carolin Arnsmeyer, Jonas Haehnle, Katrin Teichert, Guillaume Landry, Jan Hofmaier, Florian Exner, Lucas Hille, Florian Kamp, Christian Thieke, Ute Ganswindt, Chiara Valentini, Tobias Hölscher, Esther Troost, Mechthild Krause, Claus Belka, Karl-Heinz Küfer, Katia Parodi, Christian Richter
Proton radiotherapy (PT) requires accurate target alignment before each treatment fraction, ideally utilizing 3D in-room X-ray computed tomography (CT) imaging. Typically, the optimal patient position is determined based on anatomical landmarks or implanted markers. In the presence of non-rigid anatomical changes, however, the planning scenario cannot be exactly reproduced and positioning should rather aim at finding the optimal position in terms of the actually applied dose. In this work, dose-guided patient alignment, implemented as multicriterial optimization (MCO) problem, was investigated in the scope of intensity-modulated and double-scattered PT (IMPT and DSPT) for the first time...
November 5, 2018: Zeitschrift Für Medizinische Physik
Reuven Edri, Idan Gal, Nadav Noor, Tom Harel, Sharon Fleischer, Nofar Adadi, Ori Green, Doron Shabat, Lior Heller, Assaf Shapira, Irit Gat-Viks, Dan Peer, Tal Dvir
Despite incremental improvements in the field of tissue engineering, no technology is currently available for producing completely autologous implants where both the cells and the scaffolding material are generated from the patient, and thus do not provoke an immune response that may lead to implant rejection. Here, a new approach is introduced to efficiently engineer any tissue type, which its differentiation cues are known, from one small tissue biopsy. Pieces of omental tissues are extracted from patients and, while the cells are reprogrammed to become induced pluripotent stem cells, the extracellular matrix is processed into an immunologically matching, thermoresponsive hydrogel...
November 8, 2018: Advanced Materials
Christopher Wu, Ching-Yu Lee, Tsung-Jen Huang, Meng-Huang Wu
Widespread spinal metastases can obscure bone landmarks and severely hinder surgical safety during pedicle screw insertion. Robot-assisted spinal surgery has demonstrated an excellent safety profile for pedicle screw insertion. Moreover, spinal surgery robotic systems can facilitate pedicle screw insertion with high-accuracy. We present a patient who had breast cancer with widespread spinal metastases, pathological vertebral fracture, and spinal cord compression with a challenge of intraoperative image recognition...
November 3, 2018: Journal of Robotic Surgery
C Russell, R W P Kissane, D P Steenson, S Chakrabarty
BACKGROUND: The demand for neuromodulatory and recording tools has resulted in a surge of publications describing techniques for fabricating devices and accessories in-house suitable for neurological recordings. However, many of these fabrication protocols use equipment which are not common to biological laboratories, thus limiting researchers to the use of commercial alternatives. New method:We have developed a simple yet robust implantable stimulating surface electrode which can be fabricated in all wet-bench laboratories...
October 30, 2018: Journal of Neuroscience Methods
Fabien B Wagner, Jean-Baptiste Mignardot, Camille G Le Goff-Mignardot, Robin Demesmaeker, Salif Komi, Marco Capogrosso, Andreas Rowald, Ismael Seáñez, Miroslav Caban, Elvira Pirondini, Molywan Vat, Laura A McCracken, Roman Heimgartner, Isabelle Fodor, Anne Watrin, Perrine Seguin, Edoardo Paoles, Katrien Van Den Keybus, Grégoire Eberle, Brigitte Schurch, Etienne Pralong, Fabio Becce, John Prior, Nicholas Buse, Rik Buschman, Esra Neufeld, Niels Kuster, Stefano Carda, Joachim von Zitzewitz, Vincent Delattre, Tim Denison, Hendrik Lambert, Karen Minassian, Jocelyne Bloch, Grégoire Courtine
Spinal cord injury leads to severe locomotor deficits or even complete leg paralysis. Here we introduce targeted spinal cord stimulation neurotechnologies that enabled voluntary control of walking in individuals who had sustained a spinal cord injury more than four years ago and presented with permanent motor deficits or complete paralysis despite extensive rehabilitation. Using an implanted pulse generator with real-time triggering capabilities, we delivered trains of spatially selective stimulation to the lumbosacral spinal cord with timing that coincided with the intended movement...
November 2018: Nature
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