Neuromodulation : journal of the International Neuromodulation Society
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This study sought to determine the association between stimulation parameters at the time of implantation and loss of efficacy on long-term follow-up. ⋯ High stimulation parameters at the time of implantation were associated with loss of efficacy at the long-term follow-up.
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The management of pain in chronic benign pancreatitis is complex. Celiac plexus neurolysis provides pain relief of variable duration. Neuromodulation of splanchnic nerves with electrodes and an implantable pulse generator system is an alternative to producing long-term pain relief with minimal complications in selected cases. ⋯ In our opinion, this is the first case of a successful long-term neuromodulation of splanchnic nerves with a permanently implanted device. The potential exists for its use in visceral abdominal pain of varied etiology, once more experience is obtained with this technique.
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Spinal cord stimulation (SCS) has been widely noted as a treatment for ischemic pain secondary to peripheral vascular disease, but evidence in the vasculitis disease state is lacking. In this paper we present two cases that exemplify the potential of SCS in this unique population. ⋯ Based on literature and our results, SCS is an effective and safe therapy for patients with therapeutically refractory vasculitis.
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Clinical Trial
Subcutaneous electrical nerve stimulation: a feasible and new method for the treatment of patients with refractory angina.
Patients suffering from chronic angina pectoris, insufficiently controllable with medication and revascularization, are an increasing medical and psychosocial problem. Although spinal cord stimulation (SCS) is proven to employ, safe, long-term anti-angina, and anti-ischemic effects for these patients, the use of SCS in this group remains limited. The reason for this restricted use is largely unknown. However, among other reasons, it may be related to the difficulties in positioning an electrode in the epidural space. We studied the feasibility and efficacy of subcutaneous implantation of an entire system. ⋯ This small feasibility study demonstrates SENS to be an effective and safe method to treat patients suffering from refractory angina. Furthermore, SENS is less invasive and appears to have less lead migrations compared with SCS.
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Case Reports
Successful peripheral nerve field stimulation for thoracic radiculitis following Brown-Sequard syndrome.
The objective of this study is to present a novel approach to the treatment of thoracic radiculitis following Brown-Sequard syndrome with peripheral nerve field stimulation (PNFS). Furthermore, we endeavor to discuss the role of PNFS in the management of refractory neuropathic pain conditions including post-traumatic and post-surgical neuropathy particularly with regards to the post-surgical spine. ⋯ Chronic radicular pain may be difficult to manage in the post-surgical patient and often requires the use of multiple therapeutic modalities. In this case, we successfully utilized PNFS as it demonstrated greater technical feasibility when compared with dorsal column stimulation and repeat surgery; therefore, it may be considered for the management of post-surgical neuropathy. Further controlled studies are needed to evaluate the efficacy of PNFS as a treatment option.