Neuromodulation : journal of the International Neuromodulation Society
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Objective. This study examines, in a retrospective fashion, the effects of intraspinal infusion therapy in 36 patients with pain of non-cancer origin. In those cases where pain was recalcitrant to the infused opiate and/or had a neuropathic component, a local anesthetic, tetracaine, was added. ⋯ Conclusion. The results support the potential utility of infusion therapy in the treatment of non-cancer pain. This treatment, however, is not without problems and should be applied judiciously and in the context of evolving guidelines.
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Objective. To test the following hypotheses, based on computer modeling studies of spinal cord stimulation, by the analysis of data from chronic pain patients: I. the probability-of-paresthesia in a dermatome is highest when the cathode is placed at the corresponding segmental level; II. variation of the rostrocaudal position of the cathode in the lower cervical/high thoracic region results in less variation of the probability-of-paresthesia in a dermatome than stimulation in more caudal regions; III. when stimulating in the midthoracic region, the probability-of-paresthesia in a dermatome is low in comparison to other regions when the cathode is not at the corresponding segmental level. Method. ⋯ Conclusion. The success to be expected from spinal cord stimulation in chronic pain management is inversely related to the thickness of the dorsal cerebrospinal fluid layer at the cathode level. Therefore, preoperative measurement from transverse images can be helpful as a predictor for success.