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Spinal cord neurostimulation

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https://www.readbyqxmd.com/read/28782181/public-regulatory-databases-as-a-source-of-insight-for-neuromodulation-devices-stimulation-parameters
#1
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...
August 7, 2017: 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
#2
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
#3
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
#4
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
#5
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
#6
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...
June 16, 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
#7
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
#8
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...
May 25, 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
#9
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
#10
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...
April 18, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28339448/efficacious-dorsal-root-ganglion-stimulation-for-painful-small-fiber-neuropathy-a-case-report
#11
Paolo Maino, Eva Koetsier, Alain Kaelin-Lang, Claudio Gobbi, Roberto Perez
Small fiber neuropathy is a disorder of the peripheral nerves with typical symptoms of burning, sharp, and shooting pain and sensory disturbances in the feet. Pain treatment depends principally on the underlying etiology with concurrent administration of antidepressants, anticonvulsants, opioids, and topical treatments like capsaicin and local anesthetics. However, treatments for pain relief in these patients frequently fail. We describe the first case of intractable painful small fiber neuropathy of the foot successfully treated with spinal cord stimulation of the left L5 dorsal root ganglion...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28262404/breakthroughs-in-the-spasticity-management-are-non-pharmacological-treatments-the-future
#12
REVIEW
Antonino Naro, Antonino Leo, Margherita Russo, Carmela Casella, Antonio Buda, Aurelio Crespantini, Bruno Porcari, Luigi Carioti, Luana Billeri, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
The present paper aims at providing an objective narrative review of the existing non-pharmacological treatments for spasticity. Whereas pharmacologic and conventional physiotherapy approaches result well effective in managing spasticity due to stroke, multiple sclerosis, traumatic brain injury, cerebral palsy and incomplete spinal cord injury, the real usefulness of the non-pharmacological ones is still debated. We performed a narrative literature review of the contribution of non-pharmacological treatments to spasticity management, focusing on the role of non-invasive neurostimulation protocols (NINM)...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28208601/surgical-neurostimulation-for-spinal-cord-injury
#13
REVIEW
Aswin Chari, Ian D Hentall, Marios C Papadopoulos, Erlick A C Pereira
Traumatic spinal cord injury (SCI) is a devastating neurological condition characterized by a constellation of symptoms including paralysis, paraesthesia, pain, cardiovascular, bladder, bowel and sexual dysfunction. Current treatment for SCI involves acute resuscitation, aggressive rehabilitation and symptomatic treatment for complications. Despite the progress in scientific understanding, regenerative therapies are lacking. In this review, we outline the current state and future potential of invasive and non-invasive neuromodulation strategies including deep brain stimulation (DBS), spinal cord stimulation (SCS), motor cortex stimulation (MCS), transcutaneous direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in the context of SCI...
February 10, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28185669/electrical-stimulation-and-monitoring-devices-of-the-cns-an-imaging-review
#14
REVIEW
Sohil H Patel, Casey H Halpern, Timothy M Shepherd, Vincent M Timpone
Functional neurosurgery is a rapidly growing field with exciting future potential applications. This article describes currently used implanted electronic devices for neurologic stimulation and monitoring. The devices to be reviewed include invasive EEG electrodes, deep brain stimulator, motor cortex stimulator, responsive neurostimulation, osteo-integrated hearing aid, middle ear implant, cochlear implant, auditory brainstem implant, vagal nerve stimulator and spinal cord stimulator. Emphasis is placed on the normal components, function, positioning, potential complications and MRI safety of these devices...
June 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28160397/alternate-intraspinal-targets-for-spinal-cord-stimulation-a-systematic-review
#15
REVIEW
George C Chang Chien, Nagy Mekhail
BACKGROUND: Conventional dorsal column spinal cord stimulation (SCS) provides less than optimal pain relief for certain pain syndromes and anatomic pain distributions. Practitioners have sought to treat these challenging therapeutic areas with stimulation of alternate intraspinal targets. OBJECTIVE: To identify and systematically review the evidence for the value neuromodulating specific neuronal targets within the spinal canal to achieve relief of chronic pain...
February 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28042918/the-neurostimulation-appropriateness-consensus-committee-nacc-safety-guidelines-for-the-reduction-of-severe-neurological-injury
#16
Timothy R Deer, Tim J Lamer, Jason E Pope, Steven M Falowski, David A Provenzano, Konstantin Slavin, Stanley Golovac, Jeffrey Arle, Joshua M Rosenow, Kayode Williams, Porter McRoberts, Samer Narouze, Sam Eldabe, Shivanand P Lad, Jose A De Andrés, Eric Buchser, Philippe Rigoard, Robert M Levy, Brian Simpson, Nagy Mekhail
INTRODUCTION: Neurostimulation involves the implantation of devices to stimulate the brain, spinal cord, or peripheral or cranial nerves for the purpose of modulating the neural activity of the targeted structures to achieve specific therapeutic effects. Surgical placement of neurostimulation devices is associated with risks of neurologic injury, as well as possible sequelae from the local or systemic effects of the intervention. The goal of the Neurostimulation Appropriateness Consensus Committee (NACC) is to improve the safety of neurostimulation...
January 2017: Neuromodulation: Journal of the International Neuromodulation Society
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 Shcharinsky
STUDY DESIGN: Prospective, observational cohort study. OBJECTIVE: This study compared in-hospital and long-term outcomes among SCS patients undergoing paddle insertion by open or MIS approaches. SUMMARY OF BACKGROUND DATA: Patients with treatment-refractory extremity neuropathic pain may benefit from spinal cord stimulation (SCS). Conventional placement of surgical paddles for an external neurostimulation trial is through open laminectomy, but minimally-invasive surgery (MIS) techniques may offer advantages...
December 16, 2016: Spine
https://www.readbyqxmd.com/read/27906080/tonic-and-burst-spinal-cord-stimulation-waveforms-for-the-treatment-of-chronic-intractable-pain-study-protocol-for-a-randomized-controlled-trial
#18
Konstantin V Slavin, Richard B North, Timothy R Deer, Peter Staats, Kristina Davis, Roni Diaz
BACKGROUND: Burst stimulation is a novel form of neurostimulation for the treatment of chronic pain which has demonstrated promise in small uncontrolled studies, but has not yet gained approval for use in the U.S. We report the study methods for an ongoing multicenter, randomized, controlled, cross-over study designed to gain United States Food and Drug Administration (FDA) approval for burst stimulation. METHODS: Participants who are candidates for a currently approved neurostimulation device were enrolled and screened...
December 1, 2016: Trials
https://www.readbyqxmd.com/read/27730706/spinal-cord-stimulation-scs-the-implantable-systems-performance-registry-ispr
#19
MULTICENTER STUDY
David M Schultz, Aaron K Calodney, Alon Y Mogilner, Todd W Weaver, Michelle D Wells, E Katherine Stromberg, Mollie P Roediger, Peter E Konrad, John T Sasaki
OBJECTIVES: The Implantable Systems Performance Registry (ISPR) was created to monitor the product performance of Medtronic Spinal Cord Stimulation (SCS) and implanted intrathecal drug infusion systems available in the United States. MATERIALS AND METHODS: Data were collected on 2605 patients from 44 centers from various geographic regions across the United States implanting and following patients with SCS systems between June 25, 2004 and January 31, 2014. Actuarial life table methods are used to estimate device performance over time...
December 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27605389/a-closed-loop-brain-machine-interface-for-epilepsy-control-using-dorsal-column-electrical-stimulation
#20
Miguel Pais-Vieira, Amol P Yadav, Derek Moreira, David Guggenmos, Amílcar Santos, Mikhail Lebedev, Miguel A L Nicolelis
Although electrical neurostimulation has been proposed as an alternative treatment for drug-resistant cases of epilepsy, current procedures such as deep brain stimulation, vagus, and trigeminal nerve stimulation are effective only in a fraction of the patients. Here we demonstrate a closed loop brain-machine interface that delivers electrical stimulation to the dorsal column (DCS) of the spinal cord to suppress epileptic seizures. Rats were implanted with cortical recording microelectrodes and spinal cord stimulating electrodes, and then injected with pentylenetetrazole to induce seizures...
September 8, 2016: Scientific Reports
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