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Spinal Cord Stimulators (spinal + cord_stimulator)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

(615) Combined Use of Cervical Spinal Cord Stimulator (SCS) and Occipital Nerve Stimulator (ONS)

PAIN MEDICINE, Issue 2 2000
Article first published online: 25 DEC 200
Author: Y. Eugene Mironer, Carolinas Center for Advanced Management of Pain A 51-year-old female patient was referred to the clinic in March 1997 with severe cervicalgia and right shoulder girdle pain. She rated her pain at 9/10 on a Visual Analog Scale (VAS). MRI showed multilevel severe spondylosis with significant neural foraminal stenosis at 3 levels. Multiple modalities of treatment (physiotherapy, epidural steroid injections, cervical plexus blocks) and a variety of medications (opioids, NSAIDs, anticonvulsants, antidepressants, etc.) failed to provide any improvement. The patient twice consulted neurosurgeons but was considered a poor surgical candidate. Finally, in July 1997, after a successful trial, a cervical SCS was implanted with the tip of the lead at level C2, achieving excellent coverage of the pain area. For the next 18 months the patient continued to do well, having minimal neck and shoulder discomfort and using only occasional oral analgesics. However, by January 1999, she developed intractable right-sided occipital neuralgia. Occipital nerve blocks were providing extremely short-term relief and the intake of different analgesics, including opioids, started to increase. In March 1999, after successful trial, an ONS was implanted. Unfortunately, it migrated shortly after implantation and had to be revised and re-anchored. After this procedure all headaches were completely controlled without medications. The patient continues to be very active, uses both stimulators daily, does not take any analgesics and rates her pain at 0/10 to 1/10 on VAS. [source]

Spinal Cord Stimulation as a Novel Approach to the Treatment of Refractory Neuropathic Mediastinal Pain

PAIN PRACTICE, Issue 4 2009
Oren T. Guttman MD
Abstract Spinal cord stimulation (SCS) offers new hope for patients with neuropathic pain. SCS "neuromodulates" the transmission and response to "painful" stimuli. The efficacy of SCS has been established in the treatment of a variety of neuropathic pain conditions and more recently in refractory angina pectoris, peripheral vascular disease, and failed back surgery syndrome. Recent publications suggest that visceral pain could be successfully treated with SCS. We report the first successful use of a spinal cord stimulator in the treatment of refractory neuropathic mediastinal, esophageal, and anterior neck pain following esophagogastrectomy. [source]

Spinal Cord Stimulation Surgical Technique for the Nonsurgically Trained

NEUROMODULATION, Issue 2009
FRCP (C), Marshall D. Bedder MD
ABSTRACT The objective of this paper is to educate physicians who implant spinal cord stimulators in current surgical techniques. Many implanters have not gone through formal surgical residencies and learn their surgical techniques during a one year Fellowship or from proctoring experience. This paper utilizes current concepts from the literature to reinforce appropriate surgical practices, which are applicable to surgeons as well as interventional pain physicians. This should be a valuable resource for all Fellows whether they are in surgical programs or pain fellowship programs. In addition, a more detailed presentation is made at the end of this paper on a proposed simple one-incision surgical technique for implantation of small internal pulse generators. This is the first publication in the literature describing such a technique and may be useful for less-experienced implanters, as well as conferring potential advantages in surgical technique. [source]

A Demonstration of a Presurgical Behavioral Medicine Evaluation for Categorizing Patients for Implantable Therapies: A Preliminary Study

NEUROMODULATION, Issue 4 2008
Kimberly Gardner Schocket PhD
ABSTRACT Objectives., The aim of the current study was to evaluate the potential efficacy of a presurgical behavioral medicine evaluation screening algorithm with patients undergoing evaluation for implantable pain management devices. Methods., Sixty patients were evaluated for prognostic recommendations regarding outcomes from surgery for spinal cord stimulators and intrathecal pumps. Diagnostic interviews, review of medical charts, and psychosocial and functional measures were used in the initial evaluation. Results., Patients were classified into one of four prognostic groups, from low to increasing risks: Green, Yellow I, Yellow II, and Red. The Green group showed the most positive biopsychosocial profile, while the Red groups showed the worst profiles. Conclusions., This preliminary study suggests that the presurgical behavioral medicine evaluation algorithm may be an effective method for categorizing patients into prognostic groups. Psychological and adverse clinical features appear to have the most power in the classification of such patients. [source]

Introduction of Infection Control Measures to Reduce Infection Associated With Implantable Pain Therapy Devices

PAIN PRACTICE, Issue 3 2007
Abram H. Burgher MD
Abstract Introduction: Implantable pain therapy devices for chronic pain include spinal cord stimulators (SCS) and intrathecal drug delivery systems (IDDS). A number of different complications can occur after implantation of these devices, but among the most serious is infection. Based on Centers for Disease Control and Prevention guidelines for prevention of surgical site infection, published literature on infection risk with implantable pain therapy devices, and recommendations from groups within our own our institution, we introduced infection control measures for all patients receiving either SCS or IDDS. Methods: After approval from the Institutional Review Board, we performed a retrospective review of patients undergoing primary implantation of SCS or IDDS before and after introduction at our institution of safety measures designed to reduce device-related infection. We compared infection incidence and compliance to infection precautions before and after introduction of these measures. Results: Thirty-four SCS or IDDS were implanted before implementation of the infection control measures and 58 were placed after. Five device-related infections occurred. Adherence to most infection precautions improved during the study period, but 100% compliance was seen only with venue used for implantation. Infection incidence declined after introduction of the safety measures, but the reduction was not statistically significant. Conclusions: Introduction of infection control measures for implantable pain therapy devices improved adherence to most infection precautions in our practice. Lack of specific documentation could have hindered practice surveillance within our group. A tool to document performance of infection control measures would be useful not only as a marker of compliance but could also serve as a reminder to perform certain safety measures. [source]