Neurosurgery
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Directional leads have garnered widespread use in deep brain stimulation (DBS) because of the ability to steer current and maximize the therapeutic window. Accurate identification of lead orientation is critical to effective programming. Although directional markers are visible on 2-dimensional imaging, precise orientation may be difficult to interpret. Recent studies have suggested methods of determining lead orientation, but these involve advanced intraoperative imaging and/or complex computational algorithms. Our objective is to develop a precise and reliable method of determining orientation of directional leads using conventional imaging techniques and readily available software. ⋯ We propose a method to determine orientation of directional DBS leads in a precise manner on conventional imaging and readily available software. This method is reliable across DBS vendors, and it can simplify this process and aid in effective programming.
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Targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) surgeries manage neuroma pain; however, there remains considerable discord regarding the best treatment strategy. We provide a direct comparison of TMR and RPNI surgery using a rodent model for the treatment of neuroma pain. ⋯ RPNI and TMR improved pain scores after neuroma resection suggesting both may be clinically feasible techniques for improving outcomes for patients with nerve injuries or those undergoing amputation.