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Epidural stimulation

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https://www.readbyqxmd.com/read/27910226/successful-treatment-of-post-dural-puncture-headache-using-epidural-fibrin-glue-patch-after-persistent-failure-of-epidural-blood-patches
#1
Kevin Wong, Brian R Monroe
OBJECTIVES: Epidural blood patch is the gold standard for the treatment of post-dural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH. CASE REPORT: This case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27910210/microbiological-evaluation-of-the-extension-wire-and-percutaneous-epidural-lead-anchor-site-following-a-2-stage-cut-down-spinal-cord-stimulator-procedure
#2
Abdul Ghaaliq Lalkhen, Mahindra Chincholkar, Jiten Patel
OBJECTIVES: There are concerns regarding bacterial colonization of the temporary extension leads and subsequent infection risk using the 2-stage cut-down approach in spinal cord stimulation (SCS). We sought to quantify the extent of bacterial colonization of the temporary extension wire and percutaneous epidural lead anchor site. MATERIALS AND METHODS: We conducted a cross-sectional observational study recruiting a pragmatic sample of 25 consecutive patients listed for a cut-down trial of SCS...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27906951/changes-in-neuroglial-activity-in-multiple-spinal-segments-after-caudal-epidural-pulsed-radiofrequency-in-a-rat-model-of-lumbar-disc-herniation
#3
Hee Kyung Cho, Jae Hoon Kang, So-Yeon Kim, Mi-Jung Choi, Se Jin Hwang, Yun-Woo Cho, Sang-Ho Ahn
BACKGROUND: Herniated lumbar discs can induce sciatica by mechanical compression and/or chemical irritation. It was recently reported that neuroglial cellular activity after pulsed radiofrequency (PRF) application to a single dorsal root ganglion (DRG) attenuated neuroglial activity at the corresponding spinal dorsal horn. Recently, caudal epidural PRF has been used to manage neuropathic pain, but evidence of molecular changes after the administration of caudal epidural PRF to attenuate neuropathic pain is lacking, and it has not been determined whether caudal epidural PRF affects neuroglial activity at different spinal levels...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27881958/motor-cortex-neurostimulation-technologies-for-chronic-post-stroke-pain-implications-of-tissue-damage-on-stimulation-currents
#4
Anthony T O'Brien, Rivadavio Amorim, R Jarrett Rushmore, Uri Eden, Linda Afifi, Laura Dipietro, Timothy Wagner, Antoni Valero-Cabré
Background: Central post stroke pain (CPSP) is a highly refractory syndrome that can occur after stroke. Primary motor cortex (M1) brain stimulation using epidural brain stimulation (EBS), transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS) have been explored as potential therapies for CPSP. These techniques have demonstrated variable clinical efficacy. It is hypothesized that changes in the stimulating currents that are caused by stroke-induced changes in brain tissue conductivity limit the efficacy of these techniques...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27881723/intraspinal-microstimulation-and-diaphragm-activation-following-cervical-spinal-cord-injury
#5
Lynne M Mercier, Elisa J Gonzalez-Rothi, Kristi A Streeter, Savannah S Posgai, Alexander S Poirier, David D Fuller, Paul J Reier, David M Baekey
Intraspinal microstimulation (ISMS), using implanted electrodes, can evoke locomotor movements after spinal cord injury (SCI), but has not been explored in the context of respiratory motor output. An advantage over epidural and direct muscle stimulation is the potential of ISMS to selectively stimulate components of the spinal respiratory network. The present study tested the hypothesis that medullary respiratory activity could be used to trigger mid-cervical ISMS and diaphragm motor unit activation in rats with cervical SCI...
November 23, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27876065/expression-of-adiponectin-receptors-in-human-and-rat-intervertebral-disc-cells-and-changes-in-receptor-expression-during-disc-degeneration-using-a-rat-tail-temporary-static-compression-model
#6
Yoshiki Terashima, Kenichiro Kakutani, Takashi Yurube, Toru Takada, Koichiro Maeno, Hiroaki Hirata, Shingo Miyazaki, Masaaki Ito, Yuji Kakiuchi, Yoshiki Takeoka, Ryosuke Kuroda, Kotaro Nishida
BACKGROUND: Adipose tissue is a large endocrine organ known to secret adiponectin, which has anti-diabetic, anti-atherogenic, and anti-inflammatory properties. Adiponectin is widely involved in systemic disease, diabetes mellitus, and cardiac infraction. This study aimed to investigate the involvement of adiponectin in intervertebral disc (IVD) degeneration. METHODS: Adipose and IVD tissues were obtained from human patients undergoing surgery (n = 4) and from skeletally mature Sprague-Dawley rats (n = 21)...
November 22, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27834648/epidural-stimulation-of-rat-spinal-cord-at-lumbosacral-segment-using-a-surface-electrode-a-computer-simulation-study
#7
Qi Xu, Li Kong, Hui Zhou, Jiping He
Clinical research indicates that the epidural spinal cord stimulation (ESCS) at lumbosacral segment has shown potential for promoting locomotor recovery in patients with incomplete spinal cord injury. However, the underlying neural mechanism needs to be determined by animal experiments. In order to refine experimental protocols, we used a finite element simulation to investigate the activation of nerve fibers in a rat spinal cord model. Our model is composed of a volume conductor model from L1 to S2 spinal segments and the McIntyre-Richard-Grill axon model, which is used to investigate the threshold of selected spinal fibers with different diameters at varied locations and predict the neural responses of any target fibers with bipolar electrode configuration...
November 4, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/27830790/a-brain-spine-interface-alleviating-gait-deficits-after-spinal-cord-injury-in-primates
#8
Marco Capogrosso, Tomislav Milekovic, David Borton, Fabien Wagner, Eduardo Martin Moraud, Jean-Baptiste Mignardot, Nicolas Buse, Jerome Gandar, Quentin Barraud, David Xing, Elodie Rey, Simone Duis, Yang Jianzhong, Wai Kin D Ko, Qin Li, Peter Detemple, Tim Denison, Silvestro Micera, Erwan Bezard, Jocelyne Bloch, Grégoire Courtine
Spinal cord injury disrupts the communication between the brain and the spinal circuits that orchestrate movement. To bypass the lesion, brain-computer interfaces have directly linked cortical activity to electrical stimulation of muscles, and have thus restored grasping abilities after hand paralysis. Theoretically, this strategy could also restore control over leg muscle activity for walking. However, replicating the complex sequence of individual muscle activation patterns underlying natural and adaptive locomotor movements poses formidable conceptual and technological challenges...
November 9, 2016: Nature
https://www.readbyqxmd.com/read/27810215/development-of-a-peripheral-nerve-stimulator-guided-technique-for-equine-pudendal-nerve-blockade
#9
K Gallacher, L C Santos, L Campoy, A J Bezuidenhout, R O Gilbert
The aim of this study was to develop and evaluate a procedure for equine pudendal nerve block using a peripheral nerve locator. In the first experiment, six ponies were used to determine the relationship between elicited muscle contractions (anal, perineal or both) and nerves serving the perineal region (pudendal, caudorectal and perineal nerves) when methylene blue dye was injected using the electrolocation technique. This experiment showed that the pudendal nerve was approached effectively when both anal and perineal twitch were elicited during electrolocation...
November 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27798422/epidural-and-transcutaneous-spinal-electrical-stimulation-for-restoration-of-movement-after-incomplete-and-complete-spinal-cord-injury
#10
Winfried Mayr, Matthias Krenn, Milan R Dimitrijevic
PURPOSE OF REVIEW: The Purpose of this review is to outline and explain the therapeutic use of electrical spinal cord stimulation (SCS) for modification of spinal motor output. Central functional stimulation provides afferent input to posterior root neurons and is applied to improve volitional movements, posture and their endurance, control spasticity, and improve bladder function or perfusion in the lower limbs. Clinical accomplishments strongly depend on each individual's physiological state and specific methodical adaptation to that physiological state...
December 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27763875/modulation-of-respiratory-output-by-cervical-epidural-stimulation-in-the-anesthetized-mouse
#11
Ruyi Huang, Serapio M Baca, Jason W Worrell, Xingquan Liu, Yeji Seo, James C Leiter, Daniel C Lu
Respiration is produced and controlled by well-characterized brain stem nuclei, but the contributions of spinal circuits to respiratory control and modulation remain under investigation. Many respiratory studies are conducted in in vitro preparations (e.g., brain stem slice) obtained from neonatal rodents. While informative, these studies do not fully recapitulate the complex afferent and efferent neural circuits that are likely to be involved in eupnea (i.e., quiet breathing). To begin to investigate spinal contributions to respiration, we electrically stimulated the cervical spinal cord during unassisted respiration in anesthetized, intact mice...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27762657/rehabilitation-strategies-after-spinal-cord-injury-inquiry-into-the-mechanisms-of-success-and-failure
#12
Marie-Pascale Côté, Marion Murray, Michel A Lemay
Body-weight supported locomotor training (BWST) promotes recovery of load-bearing stepping in lower mammals, but its efficacy in individuals with a spinal cord injury (SCI) is limited and highly dependent on injury severity. While animal models with complete spinal transections recover stepping with step-training, motor complete SCI individuals do not, despite similarly intensive training. In this review, we examine the significant differences between humans and animal models that may explain this discrepancy in the results obtained with BWST...
November 21, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27759502/an-ovine-model-of-spinal-cord-injury
#13
Saul Wilson, Kingsley O Abode-Iyamah, John W Miller, Chandan G Reddy, Sina Safayi, Douglas C Fredericks, Nicholas D Jeffery, Nicole A DeVries-Watson, Sara K Shivapour, Stephanus Viljoen, Brian D Dalm, Katherine N Gibson-Corley, Michael D Johnson, George T Gillies, Matthew A Howard
OBJECTIVE: To develop a large animal model of spinal cord injury (SCI), for use in translational studies of spinal cord stimulation (SCS) in the treatment of spasticity. We seek to establish thresholds for the SCS parameters associated with reduction of post-SCI spasticity in the pelvic limbs, with implications for patients. STUDY DESIGN: The weight-drop method was used to create a moderate SCI in adult sheep, leading to mild spasticity in the pelvic limbs. Electrodes for electromyography (EMG) and an epidural spinal cord stimulator were then implanted...
October 19, 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/27744081/comparison-of-clinical-efficacy-and-computed-tomographic-analysis-of-lead-position-between-three-column-and-five-column-paddle-leads-spinal-cord-stimulation-for-failed-back-surgery-syndrome
#14
Jin-Gyu Choi, Sang-Woo Ha, Byung-Chul Son
OBJECTIVES: The authors investigated the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between three-column and five-column paddle lead SCS in patients with FBSS. MATERIALS AND METHODS: In 21 patients who underwent paddle lead SCS at T9 (three-column, n = 9; five-column, n =12) for FBSS, a 12-month follow-up numerical rating scale, percent pain relief, and CT assessment of contact angle and percent reduction of T9 canal area were investigated...
October 12, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27701161/bioelectric-medicine-and-devices-for-the-treatment-of-spinal-cord-injury
#15
Tess Torregrosa, Ryan A Koppes
Recovery of motor control is paramount for patients living with paralysis following spinal cord injury (SCI). While a cure or regenerative intervention remains on the horizon for the treatment of SCI, a number of neuroprosthetic devices have been employed to treat and mitigate the symptoms of paralysis associated with injuries to the spinal column and associated comorbidities. The recent success of epidural stimulation to restore voluntary motor function in the lower limbs of a small cohort of patients has breathed new life into the promise of electric-based medicine...
2016: Cells, Tissues, Organs
https://www.readbyqxmd.com/read/27687357/regional-anesthesia-practice-in-china-a-survey
#16
Jeffrey Huang, Huan Gao
STUDY OBJECTIVE: Neuraxial anesthesia has been widely used in China. Recently, Chinese anesthesiologists have applied nerve stimulator and ultrasound guidance for peripheral nerve blocks. Nationwide surveys about regional anesthesia practices in China are lacking. We surveyed Chinese anesthesiologists about regional anesthesia techniques, preference, drug selections, complications, and treatments. DESIGN: A survey was sent to all anesthesiologist members by WeChat...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27658771/current-experience-of-spinal-neuromodulation-in-chronic-pain-is-there-a-role-in-children-and-young-people
#17
David Pang
INTRODUCTION: Chronic pain in children has been an under-recognized problem compared to adult pain. The aim of management is to help children and their families cope with the symptoms rather than a cure. Current medical treatments to reduce pain intensity are often short lived, poorly tolerated or ineffective. RESULTS: The use of electrical stimulation to treat pain is the current basis of modern Neuromodulation at the spinal cord and has been well established as spinal cord stimulation in adult practice...
August 9, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27590457/myocardial-microvascular-responsiveness-during-acute-cardiac-sympathectomy-induced-by-thoracic-epidural-anesthesia
#18
Carolien S E Bulte, Christa Boer, Koen J Hartemink, Otto Kamp, Martijn W Heymans, Stephen A Loer, Stefano F de Marchi, Rolf Vogel, R Arthur Bouwman
OBJECTIVE: To evaluate the effect of acute cardiac sympathectomy by thoracic epidural anesthesia on myocardial blood flow and microvascular function. DESIGN: A prospective observational study. SETTING: The study was conducted in a tertiary teaching hospital. PARTICIPANTS: Ten patients with a mean age of 48 years (range 22-63 years) scheduled for thoracic surgery. INTERVENTIONS: Myocardial contrast echocardiography was used to study myocardial blood flow and microvascular responsiveness at rest, during adenosine-induced hyperemia, and after sympathetic stimulation by the cold pressor test...
May 25, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27589093/activation-of-cannabinoid-cb1-receptor-contributes-to-suppression-of-spinal-nociceptive-transmission-and-inhibition-of-mechanical-hypersensitivity-by-a%C3%AE-fiber-stimulation
#19
Fei Yang, Qian Xu, Bin Shu, Vinod Tiwari, Shao-Qiu He, Louis P Vera-Portocarrero, Xinzhong Dong, Bengt Linderoth, Srinivasa N Raja, Yun Wang, Yun Guan
Activation of Aβ-fibers is an intrinsic feature of spinal cord stimulation (SCS) pain therapy. Cannabinoid receptor type 1 (CB1) is important to neuronal plasticity and pain modulation, but its role in SCS-induced pain inhibition remains unclear. In this study, we showed that CB1 receptors are expressed in both excitatory and inhibitory interneurons in substantia gelatinosa (SG). Patch-clamp recording of the evoked excitatory postsynaptic currents (eEPSCs) in mice after spinal nerve ligation (SNL) showed that electrical stimulation of Aβ-fibers (Aβ-ES) using clinical SCS-like parameters (50 Hz, 0...
November 2016: Pain
https://www.readbyqxmd.com/read/27586244/neurophysiological-intraoperative-monitoring-during-an-optic-nerve-schwannoma-removal
#20
Daniel San-Juan, Manuel Escanio Cortés, Martha Tena-Suck, Adolfo Josué Orozco Garduño, Jesús Alejandro López Pizano, Jonathan Villanueva Domínguez, Maricarmen Fernández Gónzalez-Aragón, Juan Luis Gómez-Amador
This paper reports the case of a patient with optic nerve schwannoma and the first use of neurophysiological intraoperative monitoring of visual evoked potentials during the removal of such tumor with no postoperative visual damage. Schwannomas are benign neoplasms of the peripheral nervous system arising from the neural crest-derived Schwann cells, these tumors are rarely located in the optic nerve and the treatment consists on surgical removal leading to high risk of damage to the visual pathway. Case report of a thirty-year-old woman with an optic nerve schwannoma...
September 1, 2016: Journal of Clinical Monitoring and Computing
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