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Neurostimulation AND Neuropathic Pain

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https://www.readbyqxmd.com/read/30078053/the-appropriate-management-of-persisting-pain-after-spine-surgery-a-european-panel-study-with-recommendations-based-on-the-rand-ucla-method
#1
Volker M Tronnier, Sam Eldabe, Jörg Franke, Frank Huygen, Philippe Rigoard, Javier de Andres Ares, Richard Assaker, Alejandro Gomez-Rice, Marco La Grua, Maarten Moens, Lieven Moke, Christophe Perruchoud, Nasir A Quraishi, Dominique A Rothenfluh, Pedram Tabatabaei, Koen Van Boxem, Carmen Vleggeert-Lankamp, Björn Zoëga, Herman J Stoevelaar
PURPOSE: Management of patients with persisting pain after spine surgery (PPSS) shows significant variability, and there is limited evidence from clinical studies to support treatment choice in daily practice. This study aimed to develop patient-specific recommendations on the management of PPSS. METHODS: Using the RAND/UCLA appropriateness method (RUAM), an international panel of 6 neurosurgeons, 6 pain specialists, and 6 orthopaedic surgeons assessed the appropriateness of 4 treatment options (conservative, minimally invasive, neurostimulation, and re-operation) for 210 clinical scenarios...
August 4, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29713421/failed-back-surgery-syndrome-a-review-article
#2
REVIEW
James R Daniell, Orso L Osti
Postsurgical spine syndrome is becoming an increasingly common challenge for clinicians who deal with spinal disorders owing to the expanding indications for spinal surgery and the aging world population. A multidisciplinary approach is most appropriate for patients who are unlikely to benefit from further formal surgical intervention. Anticonvulsant medications are effective in managing neuropathic pain after surgery, whereas opioids are rarely beneficial. Neuromodulation via a surgically implanted dorsal column neurostimulator is gaining popularity owing to its substantial superiority over conventional medical management and/or further surgical intervention...
April 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29526043/spinal-cord-stimulation-clinical-efficacy-and-potential-mechanisms
#3
REVIEW
Andrei D Sdrulla, Yun Guan, Srinivasa N Raja
Spinal cord stimulation (SCS) is a minimally invasive therapy used for the treatment of chronic neuropathic pain. SCS is a safe and effective alternative to medications such as opioids, and multiple randomized controlled studies have demonstrated efficacy for difficult-to-treat neuropathic conditions such as failed back surgery syndrome. Conventional SCS is believed mediate pain relief via activation of dorsal column Aβ fibers, resulting in variable effects on sensory and pain thresholds, and measurable alterations in higher order cortical processing...
March 11, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29510963/-conventional-analgesics-and-non-pharmacological-multidisciplinary-therapeutic-treatment-in-endometriosis-cngof-has-endometriosis-guidelines
#4
J-M Wattier
A major symptom of endometriosis is pelvic pain with a wide range of intensity, rhythm, type, and expression, without clearly established relationship between pain and the disease. Endometriosis-associated pain has physical, psychological/behavioral and social consequences with a significant impact on patient quality-of-life in relation with the biopsychosocial model of chronic pain. Pain assessment in all of its dimensions, as well as assessing the consequences of pain is therefore a crucial part of therapeutic management...
March 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29447137/emerging-therapies-for-neuropathic-pain-new-molecules-or-new-indications-for-old-treatments
#5
Didier Bouhassira, Nadine Attal
Neuropathic pain represents a highly unmet medical need because most of the available treatments have a modest efficacy or dose-limiting side effects. Hence, novel therapeutic perspectives are warranted. Many compounds acting on new pain targets are in preclinical or early clinical development. Only few clinical trials have suggested their clinical relevance in neuropathic pain. This concerns in particular NaV1.7 antagonists and angiotensin type II inhibitors. Another type of emerging drug therapy in neuropathic pain is represented by drugs largely used for other indications, such as botulinum toxin A and the antiepileptic oxcarbazepine, which have recently found to be effective in peripheral neuropathic pain...
March 2018: Pain
https://www.readbyqxmd.com/read/29441289/high-density-in-spinal-cord-stimulation-virtual-expert-registry-discover-study-protocol-for-a-prospective-observational-trial
#6
Mats De Jaeger, Robbert-Jan van Hooff, Lisa Goudman, Alexis Valenzuela Espinoza, Raf Brouns, Martine Puylaert, Wim Duyvendak, Maarten Moens
Background: Spinal cord stimulation (SCS) is a proven and effective treatment for neuropathic pain conditions such as failed back surgery syndrome (FBSS). The hypothesis that different settings for SCS parameters activate unique, pain-relieving mechanisms has boosted the development of various SCS paradigms. High density spinal cord stimulation (HD-SCS) is one of those promising, novel stimulation forms characterized by subthreshold stimulation, delivering more pulses per second and a higher pulse density to the spinal cord than conventional SCS...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29178511/neurostimulation-for-refractory-cervicogenic-headache-a-three-year-retrospective-study
#7
REVIEW
Marzieh Eghtesadi, Elizabeth Leroux, Marie-Pierre Fournier-Gosselin, Paul Lespérance, Luc Marchand, Heather Pim, Andreea Adelina Artenie, Line Beaudet, Guy Pierre Boudreau
BACKGROUND: Occipital nerve stimulation (ONS) has been used for the treatment of neuropathic pain conditions and could be a therapeutic approach for refractory cervicogenic headache (CeH). AIM: The aim of this study is to assess the efficacy and safety of unilateral ONS in patients suffering from refractory CeH. METHODS: We conducted a retrospective chart review on patients implanted from 2011 to 2013 at CHUM. The primary outcome was a 50% reduction in headache days per month...
April 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29152818/electrical-stimulation-of-dorsal-root-ganglion-in-the-context-of-pain-a-systematic-review-of-in-vitro-and-in-vivo-animal-model-studies
#8
REVIEW
Ivana Vuka, Katarina Vučić, Tihana Repić, Lejla Ferhatović Hamzić, Damir Sapunar, Livia Puljak
OBJECTIVE: Dorsal root ganglion (DRG) has recently emerged as an attractive target for neuromodulation therapy since primary sensory neurons and their soma in DRGs are important sites for pathophysiologic changes that lead to neuropathic pain. Our aim was to create evidence synthesis about the effects of electrical stimulation of DRG in the context of pain from in vitro and in vivo animal models, analyze methodology and quality of studies in the field. METHODS: For conducting systematic review we searched three data bases: MEDLINE, Embase and Web of Science...
April 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29030173/a-novel-miniature-wireless-neurostimulator-in-the-management-of-chronic-craniofacial-pain-preliminary-results-from-a-prospective-pilot-study
#9
Richard L Weiner, Carlos Montes Garcia, Niek Vanquathem
OBJECTIVE: To report a novel wireless neuromodulation system for treatment of refractory craniofacial pain. BACKGROUND: Previous studies utilizing peripheral nerve stimulation (PNS) of the occipital and trigeminal nerves reported positive outcomes for alleviating neuropathic pain localized to the craniofacial and occipital areas. However several technological limitations and cosmetic concerns inhibited a more widespread acceptance and use of neuromodulation. Also, a relatively high incidence of adverse events like electrode erosions, dislocation, wire fracture and/or infection at the surgical site mandates a change in our approach to neuromodulation technology and implant techniques in the craniofacial region...
October 10, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28673596/intra-spinal-microstimulation-may-alleviate-chronic-pain-after-spinal-cord-injury
#10
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/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#11
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
April 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28518084/subcutaneous-trigeminal-nerve-field-stimulation-for-refractory-facial-pain
#12
Martin Jakobs, Sigrid Schuh-Hofer, Andreas Unterberg, Rezvan Ahmadi
Chronic or neuropathic trigeminal facial pain can be challenging to treat. Neurosurgical procedures should be applied when conservative treatment fails. Neuromodulation techniques for chronic facial pain include deep brain stimulation and motor cortex stimulation, which are complex to perform. Subcutaneous nerve field stimulation is certified for chronic back pain and is the least invasive form of neuromodulation. We applied this technique to treat chronic and neuropathic trigeminal pain as an individual therapy concept...
May 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28493519/neurotransmitters-behind-pain-relief-with-transcranial-magnetic-stimulation-positron-emission-tomography-evidence-for-release-of-endogenous-opioids
#13
S Lamusuo, J Hirvonen, P Lindholm, I K Martikainen, N Hagelberg, R Parkkola, T Taiminen, J Hietala, S Helin, A Virtanen, A Pertovaara, S K Jääskeläinen
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) at M1/S1 cortex has been shown to alleviate neuropathic pain. OBJECTIVES: To investigate the possible neurobiological correlates of cortical neurostimulation for the pain relief. METHODS: We studied the effects of M1/S1 rTMS on nociception, brain dopamine D2 and μ-opioid receptors using a randomized, sham-controlled, double-blinded crossover study design and 3D-positron emission tomography (PET)...
October 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28419784/four-extremity-neurostimulation-using-two-cervical-octapolar-leads-and-high-frequency-of-10-khz
#14
Shervin Harandi, Leonardo Kapural
OBJECTIVES AND METHODS: A few published reports describe successful clinical use of low-frequency spinal cord stimulation (SCS) in the cervical spine resulting in bilateral upper and lower extremity pain relief. A major side-effect when using this modality of SCS is the uneven intensity of paresthesias, which are frequently excessive in upper extremities while attempting to achieve optimal paresthesia coverage in all 4 extremities. RESULTS AND CONCLUSIONS: Here we describe a successful case of high-frequency SCS at 10 kHz where profound control of neuropathic pain of all 4 extremities was achieved without the complication of paresthesias...
February 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28042909/the-neurostimulation-appropriateness-consensus-committee-nacc-recommendations-for-infection-prevention-and-management
#15
Timothy R Deer, David A Provenzano, Michael Hanes, Jason E Pope, Simon J Thomson, Marc A Russo, Tory McJunkin, Michael Saulino, Louis J Raso, Shivanand P Lad, Samer Narouze, Steven M Falowski, Robert M Levy, Ganesan Baranidharan, Stanley Golovac, Didier Demesmin, William O Witt, Brian Simpson, Elliot Krames, Nagy Mekhail
INTRODUCTION: The use of neurostimulation for pain has been an established therapy for many decades and is a major tool in the arsenal to treat neuropathic pain syndromes. Level I evidence has recently been presented to substantiate the therapy, but this is balanced against the risk of complications of an interventional technique. METHODS: The Neurostimulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society convened an international panel of well published and diverse physicians to examine the best practices for infection mitigation and management in patients undergoing neurostimulation...
January 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28030470/dorsal-root-ganglion-stimulation-yielded-higher-treatment-success-rate-for-complex-regional-pain-syndrome-and-causalgia-at-3-and-12-months-a-randomized-comparative-trial
#16
RANDOMIZED CONTROLLED TRIAL
Timothy R Deer, Robert M Levy, Jeffery Kramer, Lawrence Poree, Kasra Amirdelfan, Eric Grigsby, Peter Staats, Allen W Burton, Abram H Burgher, Jon Obray, James Scowcroft, Stan Golovac, Leonardo Kapural, Richard Paicius, Christopher Kim, Jason Pope, Thomas Yearwood, Sam Samuel, W Porter McRoberts, Hazmer Cassim, Mark Netherton, Nathan Miller, Michael Schaufele, Edward Tavel, Timothy Davis, Kristina Davis, Linda Johnson, Nagy Mekhail
Animal and human studies indicate that electrical stimulation of dorsal root ganglion (DRG) neurons may modulate neuropathic pain signals. ACCURATE, a pivotal, prospective, multicenter, randomized comparative effectiveness trial, was conducted in 152 subjects diagnosed with complex regional pain syndrome or causalgia in the lower extremities. Subjects received neurostimulation of the DRG or dorsal column (spinal cord stimulation, SCS). The primary end point was a composite of safety and efficacy at 3 months, and subjects were assessed through 12 months for long-term outcomes and adverse events...
April 2017: Pain
https://www.readbyqxmd.com/read/27997509/minimally-invasive-placement-of-spinal-cord-stimulator-paddle-electrodes-is-associated-with-improved-perioperative-and-long-term-experience-among-neuropathic-pain-patients
#17
Mohammed F Shamji, Darcia Paul, Alina Mednikov
STUDY DESIGN: Prospective, observational cohort study. OBJECTIVE: This study compared in-hospital and long-term outcomes among spinal cord stimulation (SCS) patients undergoing paddle insertion by open or minimally invasive surgery (MIS) approaches. SUMMARY OF BACKGROUND DATA: Patients with treatment-refractory extremity neuropathic pain may benefit from SCS. Conventional placement of surgical paddles for an external neurostimulation trial is through open laminectomy, but MIS techniques may offer advantages...
March 1, 2018: Spine
https://www.readbyqxmd.com/read/27919593/stimulation-of-the-gasserian-ganglion-in-the-treatment-of-refractory-trigeminal-neuropathy
#18
Lise Kustermans, Jean-Pierre Van Buyten, Iris Smet, Wim Coucke, Constantinus Politis
OBJECTIVES: We evaluated the effectiveness of a custom-made neurostimulator with which to treat patients for refractory trigeminal neuropathic pain (TNP) at the level of the Gasserian ganglion. MATERIALS AND METHODS: A retrospective analysis of 22 patients referred to our pain clinic, AZ Sint-Nikolaas, between 2010 and 2015, was conducted using the McGill Pain and EuroQoL questionnaire before, two weeks after, and at the final follow-up after neurostimulator treatment...
January 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27704502/neuropathic-pain
#19
REVIEW
Janne Gierthmühlen, Ralf Baron
Diagnosing neuropathic pain and distinguishing it from nociceptive pain can be challenging, but is essential because both forms of pain require different treatment strategies. The diagnosis of neuropathic pain is primarily based on clinical findings. Therefore, a careful, focused history and an examination of the signs characteristic of neuropathic pain are crucial. Imaging techniques and electrophysiological examinations, as well as punch skin biopsy can support the clinical diagnosis. Ideally, treatment should be individualized using a mechanism-based approach...
October 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27511815/ean-guidelines-on-central-neurostimulation-therapy-in-chronic-pain-conditions
#20
REVIEW
G Cruccu, L Garcia-Larrea, P Hansson, M Keindl, J-P Lefaucheur, W Paulus, R Taylor, V Tronnier, A Truini, N Attal
BACKGROUND AND PURPOSE: Our aim was to update previous European Federation of Neurological Societies guidelines on neurostimulation for neuropathic pain, expanding the search to new techniques and to chronic pain conditions other than neuropathic pain, and assessing the evidence with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. METHODS: A systematic review and meta-analysis of trials published between 2006 and December 2014 was conducted...
October 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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