Neuromodulation : journal of the International Neuromodulation Society
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Objective. To present different aspects and advantages of the laparoscopic implantation of a peripheral nerve stimulator adjacent to the pelvic nerves, aimed at treating intractable pelvic neuralgia by means of neuromodulation-the laparoscopic implantation of neuroprothesis (LION) procedure. Materials and Methods. We report here a series of three patients with different types and etiologies of chronic pelvic neuralgia who underwent laparoscopy for implantation of a peripheral nerve stimulator for neuromodulation, the first for neuromodulation of the ilioinguinal and pudendal nerves, the second for neuromodulation of the sciatic nerve, and the third for neuromodulation of the sacral nerve roots. ⋯ Conclusions. Laparoscopy allows optimal implantation of electrodes on all pelvic nerves through a minimally invasive approach. In addition, it permits new applications of neuromodulation for pelvic polyneuropathies or mononeuropathy, not covered by classical spinal cord or transcutaneous techniques.
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Objectives. This pilot study aims to validate the hypothesis that a smaller distance between spinal cord stimulation (SCS) lead and spinal cord results in more extensive paresthesia and less energy consumption. Materials and Methods. After insertion of a percutaneous SCS lead in patients with chronic pain (condition A), a first catheter was temporarily placed alongside the lead (condition B), and a second catheter was placed on the other side of the lead (condition C). ⋯ Results. Paresthesia coverage in all six patients was increased markedly in condition C when compared to condition A, whereas the mean values of PT, MC, and therapeutic range (MC/PT) dropped by 22%, 14%, and 13%, respectively. Conclusions. The results suggest that paresthesia coverage is increased when the space between the SCS lead and spinal cord gets smaller, whereas PT and energy consumption are reduced.
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Objectives. Newly developed bidirectional modulated sine waves (BMW) might provide some derived benefit to patients with low back pain. Pain relief by transcutaneous electric nerve stimulation (TENS) with BMWs was tested. Materials and Methods. Analgesic effects of BMWs and conventional bidirectional pulsed waves on chronic back pain in 28 patients were compared, and effects of repeated TENS using BMWs on chronic back pain were investigated in 21 patients by means of a randomized double-blind, sham-controlled, parallel-group method. ⋯ Weekly repeated treatments using massage and TENS with BMWs for 5 weeks resulted in a decrease of NRS, but there were no significant differences between the TENS plus massage and sham TENS plus massage groups. Conclusions. This study shows that TENS with BMWs significantly inhibits chronic back pain, and treatment effects are attained within a day. The results also suggest that there were no statistically significant long-term effects of TENS with BMW in the repeated treatment.