Neuromodulation : journal of the International Neuromodulation Society
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Sacral nerve root stimulation (SNRS) is known to be effective in the treatment of pelvic motor dysfunction(1-4). Bladder and urethral motor disorders commonly treated include urinary urge incontinence, voiding/detrusor dysfunction, and urgency/frequency syndromes. To date, neurostimulation specific to bladder and urethral dysfunction has applied a unilateral, trans-sacral approach. (Interstim, Medtronic, Minneapolis, MN) Despite some success, this method has been associated with technical failures in maintaining electrode position(5,6). As an alternative, this case report describes the selective epidural application of a cephalocaudal ("retrograde") lead insertion method in a patient with severe detrusor dysfunction and urinary urge incontinence(7).
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This case study is presented to exemplify the application of a perineuromal approach in the treatment of recalcitrant occipital neuralgia. The patient was a 49-year-old female with severe and disabling occipital neuralgia. The pain persisted despite several surgical procedures, injections in the affected area, and medications. ⋯ This case illustrates the possible utilization of perineuromal stimulation in the treatment of occipital neuralgia. The specific mechanism of action remains unclear. Replication and controlled studies are required to determine the general applicability of this approach.
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The objective of this paper is to examine the outcomes of patients with intractable low-back pain treated with epidural spinal cord stimulation (SCS) utilizing paddle electrodes and a radio frequency (RF) stimulator. A multicenter prospective study was performed to collect data from patients suffering from chronic low-back pain. The study was designed to collect data from 60 patients at four centers and examine their outcomes at, or up to two years post implantation. ⋯ The majority of patients reported that the procedure was worthwhile (92% at six months, 88% at one year). No patient indicated that the procedure was not worthwhile. We conclude that SCS proved beneficial at one year for the treatment of patients with chronic low back and leg pain.