Neuromodulation : journal of the International Neuromodulation Society
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Background. Spinal cord stimulation (SCS) is being used with increasing frequency in the treatment of various chronic pain conditions. There is a paucity of reliable outcome data regarding changes in pain tolerance and peripheral sensory nerve function. ⋯ The results of this study appear to substantiate the postulates that both segmental and suprasegmental effects are involved in SCS-mediated analgesia. SCS modulates segmental large afferent fiber input as reflected by a statistically significant increase in large fiber CPTs (2000 Hz) at the symptomatic site post-SCS. A statistically significant increase in small fiber (5 Hz) CPTs at the control site suggests a central sensory (suprasegmental) modulating effect on nociceptive fiber activity. sNCT testing provided reliable outcome data for evaluating response to SCS.
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Objective. Post-herniorrhaphy pain syndrome can be difficult to treat. The exact mechanism of pain is not always apparent. ⋯ Conclusion. Post-herniorrhaphy pain can have the same features of both nociceptive and neuropathic pain syndromes. In cases which have failed conservative therapy we believe that a trial of spinal cord stimulation is warranted as in other cases of neuropathic pain syndromes.
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Objective. To assess the effect of spinal cord stimulation in patients with severe, inoperable peripheral vascular disease, and uncontrolled pain. Patients and methods. ⋯ Conclusions. Twenty patients with end-stage peripheral vascular disease were implanted with spinal cord stimulators and followed for five years, until amputation or end of life, showing excellent results for limb salvage and minimal complications. The current literature regarding the use of spinal cord stimulation for peripheral vascular disease is reviewed, supporting its benefit for limb salvage and pain relief.
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Objective. The aim of the paper is to present various relatively simple functional electrical stimulation (FES) systems that affect neural circuits and reflex behavior by providing necessary peripheral input to the lower extremities of incomplete spinal cord injured (SCI) persons. Methods. ⋯ The information about several gait variables can be first integrated and afterwards delivered to the walking subject as a single command. Conclusions. Significant improvements in the duration of the double support phase, metabolic energy expenditure, and physiologic cost index were observed when using FES-assisted training of walking in incomplete SCI persons.