Neuromodulation : journal of the International Neuromodulation Society
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Eddy currents in the metal shell and copper losses in the coils generate heat in rechargeable neurostimulators, which increases the temperature of the adjacent tissue, potentially causing thermal damage of implant patients. Hence, there is an urgent need for a simple self-help method to measure the temperature of such subcutaneous devices. ⋯ A convenient method was then given to monitor the adjacent skin temperature to evaluate the thermal hazards with a skin temperature threshold of 41°C. The proposed approach can be easily implemented by an implant patient at home to reduce the thermal risk, ease patient anxiety, and improve clinical outcomes.
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The aim of the study was to investigate the predictive value of percutaneous electrical nerve stimulation (PENS) in peripheral nerve stimulation (PNS) for chronic neuropathic pain. ⋯ Predicting response to PNS is crucial to reduce the number of patients implanted in vain. To adopt PENS via electroacupuncture needles as a percutaneous simulation method for PNS seemed to be feasible. The technique presented herein bears the potential to improve patient selection combined with reduced invasiveness. The presented results are encouraging and deliver a starting point for further trials.
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We hypothesize that intrathecal (IT) granulomas arising from the IT infusion of several opiates may result from the degranulation of meningeal mast cells (MC). Given functional covariance between cutaneous and meningeal MC, we propose that opioids that do not degranulate cutaneous MC will not produce a granuloma. An opioid meeting this criteria is the phenylpiperadine alfentanil HCl. ⋯ These results support the hypothesis linking MC degranulation and IT granulomas.
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Spinal cord stimulation is a well-established treatment for recalcitrant pain syndromes such as failed back surgery syndrome. Techniques minimizing surgical time and incision size and increasing lead stability are of great value to both the patient and implanting physician. We present a consecutive case series review of ten permanent percutaneous spinal cord implants utilizing a novel lead fixation device. The purpose of this case series review is to present initial findings of the minimized incision size and thoughts surrounding the new device and technique. ⋯ These data suggest a new method of fixation can be utilized for percutaneous spinal cord stimulation that allows a reduction in incision size. Intuitively, reduction in incision size is relevant with regard to tissue morbidity and may also have implications with regard to infection. Use of the device may also reduce operating room and anesthesia time as well as provide greater stability than standard suture.