Neuromodulation : journal of the International Neuromodulation Society
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Objectives. To investigate the different approaches in the field of functional electrical stimulation (FES) control of gait and address fundamental perquisites to enable FES walking systems to become safer, more practical, and therefore clinically efficacious. Design. Systematic review was conducted from electronic data bases up to March 2008. Studies with innovative control strategies were highlighted for analysis, but all relevant literatures were described to deliver a broad viewpoint. ⋯ Finite state controllers based on a set of deterministic rules to process feedback signals seemed more suitable to provide accurate command-and-control compared with dynamic or neural network controllers. Conclusions. Progress in the development of closed-loop FES walking systems has been impeded by their lack of practicality. In the near future, this obstacle could be overcome via implanted systems, especially if using controllers based on deterministic rule sets derived from motion sensor feedback.
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Objective. Percutaneous techniques for occipital nerve stimulation have been in the literature since 1999. Lead migration continues to be the most common complication to the technique. The authors would like to introduce a new technique for revision of a superficially migrated occipital nerve stimulator electrode. ⋯ He had no signs of infection and full return of prior function of the stimulator at two weeks and three-month follow-up visits. Conclusion. This case demonstrates a new safer technique for revision of a superficially migrated occipital nerve stimulator lead. The technique is a more direct and simple solution to a common problem in the percutaneous placement of occipital nerve stimulators.
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Introduction. Spinal cord stimulation (SCS) is used clinically by many pain physicians and neurosurgeons alike without regard to their own outcome data. Methods. We reviewed our 20-year experience retrospectively of patients receiving SCS implants and analyzed our data by pain type and group. Results. We present 260 patients, 140 men and 120 women. ⋯ The therapy was not free of complications. The preponderance of our patients was patients with the diagnosis of PVD and our results in this group of patients were excellent. These excellent results of more than 90% improvement suggest to us that SCS be considered as a first-line approach to the clinical management of patients with pain and ulcer of PVD.
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Introduction. Peripheral nerve stimulation has become a useful tool in neuromodulation in the treatment of chronic and intractable pain syndromes. Method. While most of the reports in the literature describe the use of a subcutaneously placed small diameter cylindric lead, we present a case report of a 37-year-old man who did not have adequate axial back stimulation with such a lead. Conclusion. He had excellent stimulation and reduction of his pain after the device was replaced with an insulated subcutaneous paddle lead.