Neuromodulation : journal of the International Neuromodulation Society
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Comparative Study
Peripheral nerve field stimulation in the treatment of postlaminectomy syndrome after multilevel spinal surgeries.
Chronic low back pain in patients with postlaminectomy syndrome (PLS) is challenging to treat, especially for patients who have undergone multilevel surgical procedures. Despite conservative therapy and available interventional pain procedures including spinal cord stimulation (SCS) and intrathecal therapies, patients may continue with intractable low back pain. Peripheral nerve field stimulation (PNFS) may represent an effective alternative treatment option for these patients when conventional treatments do not provide adequate relief of intractable low back pain. ⋯ PNFS may be more effective in treating intractable low back pain than SCS in patients with PLS after multilevel spinal surgeries.
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Case Reports Randomized Controlled Trial
Deep brain stimulation for early-stage Parkinson's disease: an illustrative case.
Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN-DBS. ⋯ This report details the first successful application of bilateral STN-DBS for early-stage PD during a clinical trial.
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Clinical Trial
Prospective analysis of the trial period for spinal cord stimulation treatment for chronic pain.
To determine patient preferences regarding the duration of trial period. ⋯ In this study, all patients could make a decision in 15 days, with successful trials requiring a shorter duration. The conversion rate was similar to rates in literature despite patients making a decision without physician input.
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Subthalamic nucleus deep brain stimulation (STN DBS) is effective for treatment of levodopa-induced dyskinesias in patients with Parkinson's disease (PD). Medical or surgical procedures requiring electrocautery may require inactivation of the pulse generators to avoid damage to the lead or extension wire or possible reprogramming of the stimulators. This generally causes only mild and temporary disability. We report a patient with previously well-controlled dyskinesias who had severe and prolonged dyskinesias following reactivation of deep brain stimulation (DBS) following an orthopedic procedure. ⋯ Clinicians caring for PD patients treated with STN DBS should be aware of the possible reappearance of severe dyskinesias arising from routine inactivation and reactivation of pulse generators for medical or surgical procedures.
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Comparative Study
Surrogate human tissue temperatures resulting from misalignment of antenna and implant during recharging of a neuromodulation device.
A synergistic experimental and numerical investigation has provided quantitative information on the response of surrogate human tissue temperatures to misalignment of the implant and antenna of neuromodulation devices during recharging. ⋯ Notwithstanding these increases, the lowest temperatures were attained by the Restore Ultra device for all operating conditions. The temperature levels achieved by the Precision Plus and Eon Mini devices were found to be greater than those for the Restore Ultra but their relative rankings depend on the thermal boundary conditions and the duration of the recharging period. The foregoing rank ordering was validated by a sensitivity study in which the heat transfer data inputted to the numerical simulation was varied systematically. The aforementioned comparisons correspond with identical recharging periods for all of the devices.