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Epidural stimulation

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https://www.readbyqxmd.com/read/29345843/does-the-use-of-epiduroscopic-lysis-of-adhesions-reduce-the-need-for-spinal-cord-stimulation-in-failed-back-surgery-syndrome-a-short-term-pilot-study
#1
S J Tuijp, J Van Zundert, P De Vooght, M Puylaert, R Mestrum, R Heylen, P Vanelderen
BACKGROUND AND AIMS: Persistent low back pain after initially successful surgery that is not attributed to structural deficits, is called failed back surgery syndrome (FBSS). When conservative and minimal invasive therapy fail, the recommended treatment is spinal cord stimulation (SCS). Because epidural fibrosis can be a contributing factor in the majority of FBSS patients, lumbosacral epiduroscopic lysis of adhesions may be considered as a less invasive alternative treatment option. We hypothesized that the use of epiduroscopic lysis of adhesions could reduce the need for SCS...
January 18, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29345393/the-protective-effect-of-spinal-cord-stimulation-postconditioning-against-spinal-cord-ischemia-reperfusion-injury-in-rabbits
#2
Huixian Li, Xiuhua Dong, Mu Jin, Weiping Cheng
BACKGROUND: Delayed paraplegia due to spinal cord ischemia/reperfusion injury (IRI) remains one of the most severe complications of thoracoabdominal aneurysm surgery, for which effective prevention and treatment is still lacking. OBJECTIVES: The current study investigates whether spinal cord stimulation (SCS) postconditioning has neuroprotective effects against spinal cord IRI. METHOD: Ninety-six New Zealand white male rabbits were randomly divided into four groups as follows: a sham group and three experimental groups (C group, 2 Hz group, and 50 Hz group) n = 24/group...
January 18, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29339580/advantages-of-soft-subdural-implants-for-the-delivery-of-electrochemical-neuromodulation-therapies-to-the-spinal-cord
#3
Marco Capogrosso, Jérôme Gandar, Nathan Greiner, Eduardo Martin Moraud, Nikolaus Wenger, Polina Shkorbatova, Pavel E Мusienko, Ivan Minev, Stephanie P Lacour, Gregoire Courtine
We recently developed soft neural interfaces enabling the delivery of electrical and chemical stimulation to the spinal cord. These stimulations restored locomotion in animal models of paralysis. Soft interfaces can be placed either below or above the dura mater. Theoretically, the subdural location combines many advantages, including increased selectivity of electrical stimulation, lower stimulation thresholds, and targeted chemical stimulation through local drug delivery. However, these advantages have not been documented, nor have their functional impact been studied in-silico or in a relevant animal model of neurological disorders using a multimodal neural interface...
January 17, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29333355/bilateral-peripheral-nerve-field-stimulation-for-intractable-coccygeal-pain-a-case-study-using-dual-lead-intercommunication
#4
Michelle Granville, Patrick T Brennan, Robert E Jacobson
Coccygeal pain is a difficult chronic pain problem with mixed response to various treatments. This is a report of a case of coccygeal pain that after failing various conservative and interventional procedures over five years was evaluated with a temporary peripheral sacral fascial lead followed by implantation of bilateral sacral paramedian leads for peripheral nerve field stimulation (PNFS). This resulted in marked pain control and resumption of full activity. The visual analog scale (VAS) pain score improved from eight pre-implant to one after implant and has remained at that level in follow-up...
November 9, 2017: Curēus
https://www.readbyqxmd.com/read/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#5
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29281943/biological-and-mechanical-factors-promote-the-osteogenesis-of-rabbit-artificial-vertebral-laminae
#6
Linli Li, Xujun Chen, Yiqun He, Youhai Dong
Reconstruction of vertebral laminae without epidural scar formation has been challenging. The success of bone formation depends on the biological and mechanical conditions of the surrounding tissues. In this study, we aimed to investigate the roles of biological and mechanical factors in the osteogenesis of artificial laminae. Mesenchymal stem cells derived from rabbit umbilical cord Wharton's Jelly were induced for osteogenic differentiation for 3 weeks before seeding on the hydroxyapatite-collagen I scaffolds to construct the tissue-engineered laminae (TEL)...
December 27, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29202726/large-reductions-in-cesarean-delivery-rates-in-china-a-qualitative-study-on-delivery-decision-making-in-the-era-of-the-two-child-policy
#7
Eileen Wang, Therese Hesketh
BACKGROUND: In 2010, China's cesarean delivery (CD) rates increased to one of the highest in the world, a significant proportion of which were without medical indication. However, recent studies have indicated some declines, coinciding with national and local efforts to promote vaginal birth, as well as the relaxation of the one-child policy. Considering these trends, we aimed to qualitatively explore attitudes towards childbirth and experiences of delivery decision-making among women and physicians...
December 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29186582/safety-of-spinal-cord-stimulation-in-patients-who-routinely-use-anticoagulants
#8
Hirah Khan, Vignessh Kumar, Zohal Ghulam-Jelani, Sarah E McCallum, Ellie Hobson, Vishad Sukul, Julie G Pilitsis
Objective: We assess the safety of performing the epidural placement or revision of spinal cord stimulation (SCS) in patients whose anticoagulation has been held (termed "anticoagulant-suspended" patients) in accordance with the 2017 Neurostimulation Appropriateness Consensus Committee (NACC) guidelines. Subjects: Patients undergoing SCS were included in this institutional review board-approved study. Design: A retrospective analysis of a prospectively collected database was performed...
November 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29178358/conventional-scs-vs-burst-scs-and-the-behavioral-effect-on-mechanical-hypersensitivity-in-a-rat-model-of-chronic-neuropathic-pain-effect-of-amplitude
#9
Koen P V Meuwissen, Jianwen Wendy Gu, Tianhe C Zhang, Elbert A J Joosten
OBJECTIVE: Various spinal cord stimulation (SCS) modes are used in the treatment of chronic neuropathic pain disorders. Conventional (Con) and Burst-SCS are hypothesized to exert analgesic effects through different stimulation-induced mechanisms. Preclinical electrophysiological findings suggest that stimulation intensity is correlated with the effectiveness of Burst-SCS. Therefore, we aimed to investigate the relation between amplitude (charge per second) and behavioral effects in a rat model of chronic neuropathic pain, for both Conventional Spinal Cord Stimulation (Con-SCS) and biphasic Burst-SCS...
November 27, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#10
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29089866/rapid-identification-of-cortical-motor-areas-in-rodents-by-high-frequency-automatic-cortical-stimulation-and-novel-motor-threshold-algorithm
#11
Mitsuaki Takemi, Elisa Castagnola, Alberto Ansaldo, Davide Ricci, Luciano Fadiga, Miki Taoka, Atsushi Iriki, Junichi Ushiba
Cortical stimulation mapping is a valuable tool to test the functional organization of the motor cortex in both basic neurophysiology (e.g., elucidating the process of motor plasticity) and clinical practice (e.g., before resecting brain tumors involving the motor cortex). However, compilation of motor maps based on the motor threshold (MT) requires a large number of cortical stimulations and is therefore time consuming. Shortening the time for mapping may reduce stress on the subjects and unveil short-term plasticity mechanisms...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29081513/localization-of-the-primary-sites-of-involvement-in-the-spinal-sensory-and-motor-pathways-for-multilevel-mri-abnormalities-in-degenerative-cervical-myelopathy
#12
Nobuaki Tadokoro, Toshikazu Tani, Kazunobu Kida, Katsuhito Kiyasu, Yusuke Kasai, Masashi Kumon, Ryuichi Takemasa, Masahiko Ikeuchi
STUDY DESIGN: Exploratory clinical study. OBJECTIVES: To localize the sites of conduction block in the spinal sensory and motor pathways for minimizing the level of surgical intervention despite MRI evidence of compression at several levels in degenerative cervical myelopathy (DCM). SETTING: Kochi Medical School Hospital, Japan. METHODS: We analyzed 83 DCM patients (69 ± 12 years) who underwent serial intervertebral recording of both ascending (A-SCEPs) and descending spinal cord-evoked potentials (D-SCEPs) after epidural and transcranial stimulation, respectively, during surgery before decompression procedures...
October 30, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29075183/the-role-of-functional-neuroanatomy-of-the-lumbar-spinal-cord-in-effect-of-epidural-stimulation
#13
Carlos A Cuellar, Aldo A Mendez, Riazul Islam, Jonathan S Calvert, Peter J Grahn, Bruce Knudsen, Tuan Pham, Kendall H Lee, Igor A Lavrov
In this study, the neuroanatomy of the swine lumbar spinal cord, particularly the spatial orientation of dorsal roots was correlated to the anatomical landmarks of the lumbar spine and to the magnitude of motor evoked potentials during epidural electrical stimulation (EES). We found that the proximity of the stimulating electrode to the dorsal roots entry zone across spinal segments was a critical factor to evoke higher peak-to-peak motor responses. Positioning the electrode close to the dorsal roots produced a significantly higher impact on motor evoked responses than rostro-caudal shift of electrode from segment to segment...
2017: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29074997/motor-recovery-after-activity-based-training-with-spinal-cord-epidural-stimulation-in-a-chronic-motor-complete-paraplegic
#14
Enrico Rejc, Claudia A Angeli, Darryn Atkinson, Susan J Harkema
The prognosis for recovery of motor function in motor complete spinal cord injured (SCI) individuals is poor. Our research team has demonstrated that lumbosacral spinal cord epidural stimulation (scES) and activity-based training can progressively promote the recovery of volitional leg movements and standing in individuals with chronic clinically complete SCI. However, scES was required to perform these motor tasks. Herein, we show the progressive recovery of voluntary leg movement and standing without scES in an individual with chronic, motor complete SCI throughout 3...
October 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29060065/a-convex-shaped-pdms-parylene-hybrid-multichannel-ecog-electrode-array
#15
Woo-Ram Lee, Changkyun Im, Chin Su Koh, Jun-Min Kim, Hyung-Cheul Shin, Jong-Mo Seo
Long-term electrode implant is a challenge for successful brain-computer interfaces (BCIs). It is well known that electrocorticography (ECoG) using flexible planar electrodes is more suitable for long-term implants than intracortical neural recordings using penetrative electrodes. In this study, we propose a convex-shaped, PDMS-parylene hybrid multi-electrode array for long-term stable ECoG recording on the brain or the spinal cord. The electrode array consists of 10 gold recording sites which show impedance values between 50 and 70 kOhm at 1 kHz with a diameter of 100 μm...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29026048/spinal-cord-stimulation-for-chronic-non-cancer-pain-a-review-of-current-evidence-and-practice
#16
S Sc Wong, C W Chan, C W Cheung
Spinal cord stimulation provides analgesia through electrical stimulation of the dorsal column of the spinal cord via electrode leads placed into the epidural space. In traditional tonic stimulation, a painful sensation is replaced with paraesthesia. Spinal cord stimulation is effective in reducing neuropathic pain, enhancing function, and improving quality of life in different chronic pain conditions. Currently, there is most evidence to support its use for failed back surgery syndrome when multidisciplinary conventional management is unsuccessful...
October 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29020054/a-novel-approach-for-automatic-visualization-and-activation-detection-of-evoked-potentials-induced-by-epidural-spinal-cord-stimulation-in-individuals-with-spinal-cord-injury
#17
Samineh Mesbah, Claudia A Angeli, Robert S Keynton, Ayman El-Baz, Susan J Harkema
Voluntary movements and the standing of spinal cord injured patients have been facilitated using lumbosacral spinal cord epidural stimulation (scES). Identifying the appropriate stimulation parameters (intensity, frequency and anode/cathode assignment) is an arduous task and requires extensive mapping of the spinal cord using evoked potentials. Effective visualization and detection of muscle evoked potentials induced by scES from the recorded electromyography (EMG) signals is critical to identify the optimal configurations and the effects of specific scES parameters on muscle activation...
2017: PloS One
https://www.readbyqxmd.com/read/28966573/a-chronically-implantable-bidirectional-neural-interface-for-non-human-primates
#18
Misako Komatsu, Eriko Sugano, Hiroshi Tomita, Naotaka Fujii
Optogenetics has potential applications in the study of epilepsy and neuroprostheses, and for studies on neural circuit dynamics. However, to achieve translation to clinical usage, optogenetic interfaces that are capable of chronic stimulation and monitoring with minimal brain trauma are required. We aimed to develop a chronically implantable device for photostimulation of the brain of non-human primates. We used a micro-light-emitting diode (LED) array with a flexible polyimide film. The array was combined with a whole-cortex electrocorticographic (ECoG) electrode array for simultaneous photostimulation and recording...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28964613/comparison-of-electrical-and-ultrasound-neurostimulation-in-rat-motor-cortex
#19
Daniel W Gulick, Tao Li, Jeffrey A Kleim, Bruce C Towe
Ultrasound (US) is known to non-invasively stimulate and modulate brain function; however, the mechanism of action is poorly understood. This study tested US stimulation of rat motor cortex (100 W/cm(2), 200 kHz) in combination with epidural cortical stimulation. US directly evoked hindlimb movement. This response occurred even with short US bursts (3 ms) and had short latency (10 ms) and long refractory (3 s) periods. Unexpectedly, the epidural cortical stimulation hindlimb response was not altered during the 3-s refractory period of the US hindlimb response...
September 27, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28943040/treatment-of-musculo-skeletal-pain-in-haemophilia
#20
REVIEW
E Carlos Rodriguez-Merchan
Musculo-skeletal pain treatment is inadequate in many haemophilic patients. Analgesics are used only by 36% of adult patients. FVIII/FIX intravenous infusion is mainly used to lessen pain, followed in frequency by usage of NSAIDS (primarily COX-2 inhibitors). In about 30% of patients, pain continues after infusion of F VIII/IX. In acute haemarthroses pain treatment must continue until total disappearance (checked by ultrasonography) and include haematologic treatment, short-term rest of the involved joint, cryotherapy, joint aspiration and analgesic medication (paracetamol in mild pain, metamizole for more intense pain, and in a few precise patients, soft opioids such as codeine or tramadol)...
September 19, 2017: Blood Reviews
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