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Spinal neurostimulation

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https://www.readbyqxmd.com/read/29713421/failed-back-surgery-syndrome-a-review-article
#1
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/29575331/retrospective-case-series-on-the-treatment-of-painful-diabetic-peripheral-neuropathy-with-dorsal-root-ganglion-stimulation
#2
Sam Eldabe, Anthony Espinet, Anders Wahlstedt, Porhan Kang, Liong Liem, Nikunj K Patel, Jan Vesper, Alicia Kimber, William Cusack, Jeffery Kramer
BACKGROUND: The dorsal root ganglion (DRG) has been identified as an important neural structure in the development and maintenance of chronic pain. We present a retrospective case series of patients with refractory painful diabetic peripheral neuropathy (PDPN) that underwent electrical stimulation of the DRG and report on changes in their overall perceived pain and complication rates. METHODS: Ten diabetic males (mean age 65.2 [SD 8.8] years) with painful symptoms of the lower limbs were enrolled and trialed with up to four quadripolar percutaneous DRG stimulation leads between L2 and L5 spinal levels...
March 25, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29566313/spinal-cord-stimulation-for-the-treatment-of-failed-neck-surgery-syndrome-outcome-of-a-prospective-case-series
#3
Corey W Hunter, Jonathan Carlson, Ajax Yang, Timothy Deer
OBJECTIVES: Spinal cord stimulation (SCS) is an accepted, cost-effective treatment option for a variety of chronic pain syndromes, including failed back surgery syndrome (FBSS). The application of SCS in the cervical spine, particularly for pain after cervical spine surgery, has been drawn into question in recent years by payers due to a purported lack of clinical evidence. To challenge this claim, we analyzed data from a prospective registry to support the use of SCS in the cervical spine for pain after spine surgery...
March 22, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29526043/spinal-cord-stimulation-clinical-efficacy-and-potential-mechanisms
#4
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/29441289/high-density-in-spinal-cord-stimulation-virtual-expert-registry-discover-study-protocol-for-a-prospective-observational-trial
#5
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/29248528/feasibility-safety-and-efficacy-of-subcutaneous-peripheral-nerve-field-stimulation-for-the-treatment-of-refractory-low-back-pain-a-two-year-single-center-study
#6
Basem Ishak, Benito Campos, Heike Brunn, Andreas W Unterberg, Rezvan Ahmadi
Chronic low back pain (CLBP) is challenging to treat. Minimal invasive neurostimulation therapies, such as subcutaneous peripheral nerve field stimulation (SPNS), improve pain relief and quality of life. The goal of the present study was to assess the usefulness, safety, and efficacy of SPNS in patients with CLBP. Twenty-six consecutive patients with CLBP were prospectively included in the study. For trial neurostimulation, two electrodes were implanted vertically at a depth of 1 cm into the subcutaneous tissue, ≤10 cm from the region of maximum pain...
December 15, 2017: Neuroscience
https://www.readbyqxmd.com/read/29244235/new-therapy-for-refractory-chronic-mechanical-low-back-pain-restorative-neurostimulation-to-activate-the-lumbar-multifidus-one-year-results-of-a-prospective-multicenter-clinical-trial
#7
Kristiaan Deckers, Kris De Smedt, Bruce Mitchell, David Vivian, Marc Russo, Peter Georgius, Matthew Green, John Vieceli, Sam Eldabe, Ashish Gulve, Jean-Pierre van Buyten, Iris Smet, Vivek Mehta, Shankar Ramaswamy, Ganesan Baranidharan, Richard Sullivan, Robert Gassin, James Rathmell, Chris Gilligan
OBJECTIVES: The purpose of the international multicenter prospective single arm clinical trial was to evaluate restorative neurostimulation eliciting episodic contraction of the lumbar multifidus for treatment of chronic mechanical low back pain (CMLBP) in patients who have failed conventional therapy and are not candidates for surgery or spinal cord stimulation (SCS). MATERIALS AND METHODS: Fifty-three subjects were implanted with a neurostimulator (ReActiv8, Mainstay Medical Limited, Dublin, Ireland)...
January 2018: Neuromodulation: Journal of the International Neuromodulation Society
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/29059697/stimulation-of-the-mesencephalic-locomotor-region-for-gait-recovery-after-stroke
#9
Felix Fluri, Uwe Malzahn, György A Homola, Michael K Schuhmann, Christoph Kleinschnitz, Jens Volkmann
OBJECTIVE: One-third of all stroke survivors are unable to walk, even after intensive physiotherapy. Thus, other concepts to restore walking are needed. Because electrical stimulation of the mesencephalic locomotor region (MLR) is known to elicit gait movements, this area might be a promising target for restorative neurostimulation in stroke patients with gait disability. The present study aims to delineate the effect of high-frequency stimulation of the MLR (MLR-HFS) on gait impairment in a rodent stroke model...
November 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28870357/neurostimulation-devices-for-the-treatment-of-neurologic-disorders
#10
REVIEW
Christine A Edwards, Abbas Kouzani, Kendall H Lee, Erika K Ross
Rapid advancements in neurostimulation technologies are providing relief to an unprecedented number of patients affected by debilitating neurologic and psychiatric disorders. Neurostimulation therapies include invasive and noninvasive approaches that involve the application of electrical stimulation to drive neural function within a circuit. This review focuses on established invasive electrical stimulation systems used clinically to induce therapeutic neuromodulation of dysfunctional neural circuitry. These implantable neurostimulation systems target specific deep subcortical, cortical, spinal, cranial, and peripheral nerve structures to modulate neuronal activity, providing therapeutic effects for a myriad of neuropsychiatric disorders...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28782181/public-regulatory-databases-as-a-source-of-insight-for-neuromodulation-devices-stimulation-parameters
#11
REVIEW
Doe Kumsa, G Karl Steinke, Gregory F Molnar, Eric M Hudak, Fred W Montague, Shawn C Kelley, Darrel F Untereker, Alan Shi, Benjamin P Hahn, Chris Condit, Hyowon Lee, Dawn Bardot, Jose A Centeno, Victor Krauthamer, Pavel A Takmakov
OBJECTIVE: The Shannon model is often used to define an expected boundary between non-damaging and damaging modes of electrical neurostimulation. Numerous preclinical studies have been performed by manufacturers of neuromodulation devices using different animal models and a broad range of stimulation parameters while developing devices for clinical use. These studies are mostly absent from peer-reviewed literature, which may lead to this information being overlooked by the scientific community...
February 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28723864/sacral-neuromodulation-for-fecal-incontinence-a-review-of-the-central-mechanisms-of-action
#12
Paul T J Janssen, Niels Komen, Jarno Melenhorst, Nicole D Bouvy, Ali Jahanshahi, Yasin Temel, Stephanie O Breukink
OBJECTIVE: Fecal incontinence (FI) has a devastating effect on the quality of life and results in social isolation. Sacral neuromodulation (SNM) is proven to be an effective, minimal invasive treatment modality for FI. Despite the increasing application of SNM, the exact mechanisms of action remain unclear. The initial assumption of peripheral motor neurostimulation is not supported by increasing evidence, which report effects of SNM outside the pelvic floor. A new hypothesis states that afferent signals to the brain are essential for a successful therapy...
September 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28714533/multicenter-retrospective-study-of-neurostimulation-with-exit-of-therapy-by-explant
#13
Jason E Pope, Timothy R Deer, Steven Falowski, David Provenzano, Michael Hanes, Salim M Hayek, Jacob Amrani, Jonathan Carlson, Ioannis Skaribas, Kris Parchuri, W Porter McRoberts, Robert Bolash, Nameer Haider, Maged Hamza, Kasra Amirdelfan, Sean Graham, Corey Hunter, Eric Lee, Sean Li, Michael Yang, Lucas Campos, Shrif Costandi, Robert Levy, Nagy Mekhail
INTRODUCTION: Spinal cord stimulation (SCS) devices are cost effective and improve function as well as quality of life. Despite the demonstrated benefits of SCS, some patients have the device explanted. We are interested in exploring the patient characteristics of those explanted. METHODS: This is a retrospective chart review of neurostimulation patients who underwent explantation at 18 centers across the United States within the previous five years. RESULTS: Data from 352 patients were collected and compiled...
July 17, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28673596/intra-spinal-microstimulation-may-alleviate-chronic-pain-after-spinal-cord-injury
#14
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/28645599/biplanar-fluoroscopy-guided-percutaneous-lead-implantation-for-spinal-cord-stimulation-technical-note
#15
Aaron Lawson McLean, Susanne Frank, Daniel Staribacher, Rolf Kalff, Rupert Reichart
INTRODUCTION: The correct positioning of spinal cord stimulator leads is assessed radiographically during their percutaneous implantation for trial stimulation. Usually the C-arm is repositioned several times to allow imaging in different planes, which may extend the total duration of surgery. The study aimed to evaluate whether the concurrent intraoperative use of 2 C-arms could safely reduce the duration of surgery. MATERIALS: This retrospective study included cases of percutaneous implantation of a spinal cord stimulation (SCS) lead for trial neurostimulation between 2006 and 2011...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28621025/dorsal-root-ganglion-stimulation-as-a-salvage-treatment-for-complex-regional-pain-syndrome-refractory-to-dorsal-column-spinal-cord-stimulation-a-case-series
#16
Ajax Yang, Corey W Hunter
OBJECTIVE: The efficacy of traditional spinal cord stimulation (t-SCS) tends to decay over time in patients with complex regional pain syndrome (CRPS). While it has been shown that dorsal root ganglion (DRG) stimulation is extremely effective in t-SCS-naïve patients with CRPS, its efficacy in patients who had previously failed t-SCS is unknown. Given that DRG-SCS and t-SCS target different spinal pathways, a failure with t-SCS should not automatically preclude a patient from attempting DRG-SCS...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28615976/clinical-utility-of-neurostimulation-devices-in-the-treatment-of-overactive-bladder-current-perspectives
#17
REVIEW
Dick Aw Janssen, Frank Mj Martens, Liesbeth L de Wall, Hendrikje Mk van Breda, John Pfa Heesakkers
OBJECTIVES: This review describes the evidence from established and experimental therapies that use electrical nerve stimulation to treat lower urinary tract dysfunction. METHODS: Clinical studies on established treatments such as percutaneous posterior tibial nerve stimulation (P-PTNS), transcutaneous electrical nerve stimulation (TENS), sacral nerve stimulation (SNS) and sacral anterior root stimulation (SARS) are evaluated. In addition, clinical evidence from experimental therapies such as dorsal genital nerve (DGN) stimulation, pudendal nerve stimulation, magnetic nerve stimulation and ankle implants for tibial nerve stimulation are evaluated...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28544432/are-10-khz-stimulation-and-burst-stimulation-fundamentally-the-same
#18
REVIEW
Dirk De Ridder, Sanjaya Perera, Sven Vanneste
BACKGROUND: Spinal cord stimulation (SCS) is routinely used for intractable pain syndromes. For SCS to be efficacious the painful area needs to be covered by SCS induced paresthesia symptoms. Recently, novel stimulation designs have been developed for spinal cord stimulation (SCS) that are superior to classical spinal cord stimulation and exert their effects without the mandatory paresthesia. Two such stimulation designs are burst stimulation and 10 kHz stimulation. OBJECTIVE: Whereas the mechanism of action of burst SCS has been partly elucidated, in that it modulates the medial pain pathway in contrast to tonic stimulation, the mechanism of action of 10 kHz SCS is still enigmatic...
October 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28441315/an-overview-of-chronic-spinal-pain-revisiting-diagnostic-categories-and-exploring-an-evolving-role-for-neurostimulation
#19
Ashwini Sharan, Jonathan Riley, Christian Hoelscher
STUDY DESIGN: Topic overview. OBJECTIVE: To describe the varied etiologies resulting in chronic spinal pain and review the current available evidence for treatments. SUMMARY OF BACKGROUND DATA: Chronic pain conditions, especially those that affect the axial back and radiate to the extremities, affect a large population. This results in pronounced disability and a high socioeconomic burden. Our understanding of the underlying mechanisms for chronic pain is limited...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28419784/four-extremity-neurostimulation-using-two-cervical-octapolar-leads-and-high-frequency-of-10-khz
#20
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
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