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Epidural stimulation

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https://www.readbyqxmd.com/read/28808583/successful-spinal-cord-stimulation-for-neuropathic-below-level-spinal-cord-injury-pain-following-complete-paraplegia-a-case-report
#1
Tim A Reck, Gunther Landmann
INTRODUCTION: Neuropathic pain is common in patients with spinal cord injury (SCI) and often difficult to treat. We report a case where epidural spinal cord stimulation (SCS) below the level of injury has been successfully applied in a patient with a complete spinal cord lesion. CASE PRESENTATION: A 53-year-old female presented with neuropathic below-level SCI pain of both lower legs and feet due to complete SCI below T5. Time and pain duration since injury was 2 years...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28803750/motor-cortex-and-spinal-cord-neuromodulation-promote-corticospinal-tract-axonal-outgrowth-and-motor-recovery-after-cervical-contusion-spinal-cord-injury
#2
N Zareen, M Shinozaki, D Ryan, H Alexander, A Amer, D Truong, N Khadka, A Sarkar, S Naeem, M Bikson, J Martin
Cervical injuries are the most common form of SCI. In this study, we used a neuromodulatory approach to promote skilled movement recovery and repair of the corticospinal tract (CST) after a moderately severe C4 midline contusion in adult rats. We used bilateral epidural intermittent theta burst (iTBS) electrical stimulation of motor cortex to promote CST axonal sprouting and cathodal trans-spinal direct current stimulation (tsDCS) to enhance spinal cord activation to motor cortex stimulation after injury. We used Finite Element Method (FEM) modeling to direct tsDCS to the cervical enlargement...
August 10, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28774283/effectiveness-of-spinal-cord-stimulation-for-painful-camptocormia-with-pisa-syndrome-in-parkinson-s-disease-a-case-report
#3
Hisanao Akiyama, Saki Nukui, Masashi Akamatu, Yasuhiro Hasegawa, Osamu Nishikido, Soichiro Inoue
BACKGROUND: Spinal cord stimulation (SCS) has recently been reported to be effective for truncal postural abnormalities such as camptocormia and Pisa syndrome in Parkinson's disease. In this case report, we describe a case of a woman with Parkinson's disease in whom SCS was effective for painful camptocormia with Pisa syndrome. CASE PRESENTATION: A 65-year-old woman was admitted to our hospital because of painful camptocormia. She had noticed resting tremor in the left upper limb and aprosody at 48 years of age...
August 3, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28754057/risk-assessments-of-epidural-analgesia-during-labor-and-delivery
#4
Antonio Herrera-Gómez, Elvira De Luna-Bertos, Javier Ramos-Torrecillas, Francisco M Ocaña-Peinado, Concepción Ruiz, Olga García-Martínez
Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28752624/paired-motor-cortex-and-cervical-epidural-electrical-stimulation-timed-to-converge-in-the-spinal-cord-promotes-lasting-increases-in-motor-responses
#5
Asht M Mishra, Ajay Pal, Disha Gupta, Jason B Carmel
Convergent activity in neural circuits can generate changes at their intersection. The rules of paired electrical stimulation are best understood for paradigms that stimulate input circuits and their targets. We took a different approach by targeting the interaction of descending motor pathways and large-diameter afferents in the spinal cord. We hypothesized that pairing stimulation of motor cortex and cervical spinal cord would strengthen motor responses through their convergence. We placed epidural electrodes over motor cortex and the dorsal cervical spinal cord in rats; motor evoked potentials (MEPs) were measured from biceps...
July 28, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28731977/interventions-for-neuropathic-pain-an-overview-of-systematic-reviews
#6
REVIEW
Svjetlana Dosenovic, Antonia Jelicic Kadic, Maja Miljanovic, Marina Biocic, Krste Boric, Marija Cavar, Nikolina Markovina, Katarina Vucic, Livia Puljak
Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28698694/efficiency-of-medetomidine-for-epidural-analgesia-effects-on-isoflurane-requirement-and-mean-systemic-arterial-blood-pressure-in-dogs
#7
Ryota Watanabe, Yukihiro Fujita
Five healthy beagle dogs anesthetized with isoflurane were administered medetomidine (α-2 adrenoceptor agonist) by the epidural route. Mean arterial pressure (MAP) and end-tidal concentration of isoflurane (ISO) were measured 1, 2.5, and 4 h after administration. Epidural administration of medetomidine reduced the isoflurane dose required to prevent changes in vital parameters following mechanical stimulation and maintained the MAP at a higher level compared to the control.
July 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28696946/optimal-treatment-for-lumbar-spinal-stenosis-an-update
#8
Janus Patel, Ian Osburn, Anne Wanaselja, Ryan Nobles
PURPOSE OF REVIEW: Our review of current literature within the past 12-24 months for the treatment of lumbar spinals stenosis (LSS) serves to update providers on recent advances and comparisons regarding therapy spanning lifestyle modification, pharmacologic therapy, minimally invasive interventions, and surgical interventions. RECENT FINDINGS: Current literature supporting the inclusion of physical therapy and gabapentin/pregabalin within an initial treatment regimen have been positive...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#9
REVIEW
V Wylde, J Dennis, A D Beswick, J Bruce, C Eccleston, N Howells, T J Peters, R Gooberman-Hill
BACKGROUND: Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28674775/hypothalamo-pituitary-adrenal-axis-after-a-single-epidural-triamcinolone-injection
#10
Ali Iranmanesh, Dakshinamurty Gullapalli, Ravinder Singh, Johannes D Veldhuis
PURPOSE: To quantify adrenocorticotropin and cortisol secretion after epidural glucocorticoid injection. METHODS: Eight men (ages 25-63 year) were studied at baseline, 1, 4, and 12 weeks after triamcinolone (80 mg) injection epidurally. Adrenocorticotropin (pg/mL) and cortisol (µg/dL) were measured every 10 min for 4 h, and after Corticotropin-releasing hormone (CRH) (1 µg/kg) injection. RESULTS: Epidural triamcinolone markedly suppressed: (1) pre-CRH injection ACTH (from 18 ± 3...
August 2017: Endocrine
https://www.readbyqxmd.com/read/28673596/intra-spinal-microstimulation-may-alleviate-chronic-pain-after-spinal-cord-injury
#11
Bin Shu, Fei Yang, Yun Guan
Chronic pain after spinal cord injury (SCI) is a form of central neuropathic pain that is debilitating and often refractory to current pharmacological treatments. Neurostimulation pain therapies, such as epidural spinal cord stimulation, have only moderate success in reducing SCI pain. The pathogenesis of SCI pain may involve a state of central neuronal hyperexcitability, especially in the spinal cord dorsal horn, that develops after injury. We hypothesize that the neuronal structures near the spinal cord injury site may be an important pain generator, and intraspinal microstimulation (ISMS) may normalize dorsal horn neuronal hyperexcitability and hence alleviate SCI pain...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28658132/emergency-1-stage-anterior-approach-for-cervical-spine-infection-complicated-by-epidural-abscess
#12
Haoxi Li, Zhaoxiong Chen, Zhiyao Yong, Xinhua Li, Yufeng Huang, Desheng Wu
It was a retrospective analysis.The aim of the study was to explore the safety and reliability of emergency 1-stage radical debridement and reconstruction using titanium mesh filled with autologous bone for patients with cervical spine infection complicated by epidural abscess.At present, cervical spine infection complicated by epidural abscess is known as a severe spine disease. Recently, case report of this disease is showing quite an increasing tendency, particularly in economically undeveloped areas and countries...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28628595/activity-based-therapy-from-basic-science-to-clinical-application-for-recovery-after-spinal-cord-injury
#13
Andrea L Behrman, Elizabeth M Ardolino, Susan J Harkema
BACKGROUND AND PURPOSE: Collaboration between scientists and clinicians effectively accelerated translation of scientific evidence for activity-based therapies (ABTs) into rehabilitation. This article addresses the basic scientific findings of activity-dependent plasticity that led to locomotor training, an ABT, and its principles to advance recovery in adult and pediatric populations with spinal cord injury (SCI). Expansion to new therapies based on these common principles is highlighted, for example, epidural stimulation...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28615341/high-frequency-epidural-stimulation-across-the-respiratory-cycle-evokes-phrenic-short-term-potentiation-after-incomplete-cervical-spinal-cord-injury
#14
Elisa J Gonzalez-Rothi, Kristi A Streeter, Marie H Hanna, Anna C Stamas, Paul J Reier, David M Baekey, David D Fuller
C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of "crossed spinal" synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60-sec and currents ranged from 100-1000 µA...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28583460/spinal-cord-compression-secondary-to-epidural-fibrosis-associated-with-percutaneously-placed-spinal-cord-stimulation-electrodes-case-report-and-review-of-the-literature
#15
Mazin Al Tamimi, Salah G Aoun, Wayne Gluf
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed either surgically by creating a laminectomy defect for paddle leads or percutaneously by inserting electrodes. They are usually not associated with major complications. There have been several reports of epidural fibrosis formation after paddle lead placement but only 1 case of excessive fibrosis following percutaneous lead placement. We describe the unique case of excessive cervical fibrosis formation with creation of tolerance phenomenon, clinically significant stenosis, cord compression, and myelopathy after percutaneous lead placement, which improved after surgical removal of the implant...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28576833/spinal-cord-stimulation-reduces-ventricular-arrhythmias-during-acute-ischemia-by-attenuation-of-regional-myocardial-excitability
#16
Kimberly Howard-Quijano, Tatsuo Takamiya, Erica A Dale, Jasmine Kipke, Yukiko Kubo, Tristan Grogan, Andyshea Afyouni, Kalyanam Shivkumar, Aman Mahajan
BACKGROUND: Myocardial ischemia creates autonomic nervous system imbalance and can trigger cardiac arrhythmias. We hypothesize that neuromodulation by spinal cord stimulation (SCS) will attenuate local cardiac sympathoexcitation from ischemia-induced increases in afferent signaling, reduce ventricular arrhythmias, and improve myocardial function during acute ischemia. METHODS: Yorkshire pigs (n=20) were randomized to SCS (50 Hz at 200μsec duration, current 90% motor threshold) or Sham for 30 min prior to ischemia...
June 2, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28560030/thoracolumbar-epidural-anaesthesia-with-0-5-bupivacaine-with-or-without-methadone-in-goats
#17
Priscila Dos Santos Silva, Paulo Fantinato-Neto, André Nicolai Elias Silva, Eduardo Harry Birgel Junior, Adriano Bonfim Carregaro
BACKGROUND: Epidural anaesthesia is one of the most commonly used locoregional techniques in ruminants. The lumbosacral epidural technique is reasonably easy to perform and requires low volumes of local anaesthetic drug to allow procedures caudal to the umbilicus. However, surgical procedures in the flank of the animal would require an increased volume of drugs. The anaesthetized area provided by thoracic epidural technique is larger than the lumbosacral technique; however the former is rather challenging to perform...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#18
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28515284/long-lasting-increase-in-axonal-excitability-after-epidurally-applied-dc
#19
Elzbieta Jankowska, Dominik Kaczmarek, Francesco Bolzoni, Ingela Hammar
Effects of direct current (DC) on nerve fibers have primarily been investigated during or just after DC application. However, locally applied cathodal DC was recently demonstrated to increase the excitability of intraspinal preterminal axonal branches for >1 h. The aim of this study was therefore to investigate whether DC evokes a similarly long-lasting increase in the excitability of myelinated axons within the dorsal columns. The excitability of dorsal column fibers stimulated epidurally was monitored by recording compound action potentials in peripheral nerves in acute experiments in deeply anesthetized rats...
August 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28489550/a-fully-integrated-wireless-soc-for-motor-function-recovery-after-spinal-cord-injury
#20
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...
June 2017: IEEE Transactions on Biomedical Circuits and Systems
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