Neuromodulation : journal of the International Neuromodulation Society
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Multicenter Study Observational Study
Results From the Partnership for Advancement in Neuromodulation Registry: A 24-Month Follow-Up.
This longitudinal, clinical outcome study was a multicenter, prospective, observational, registry with a 24-month assessment of patients implanted with spinal cord stimulation (SCS) systems for the management of chronic pain of the trunk and/or limbs. ⋯ Most patients experienced substantial pain relief and a significant improvement in all outcome measures. These results further support the safety, efficacy, and sustainability of SCS in clinical practice.
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Comparative Study
Health Services Utilization and Payments in Patients With Cancer Pain: A Comparison of Intrathecal Drug Delivery vs. Conventional Medical Management.
To compare health services utilization and payments for cancer patients who received an implantable intrathecal drug delivery (IDD) system, consisting of a pump and catheter, vs. conventional medical management (CMM) for the treatment of cancer-related pain. ⋯ Despite the high initial cost of IDD, this analysis suggests that patients with IDD incur lower medical utilization and payments over the first year post-implant. Further analysis comprised of a larger, longitudinal sample would contribute to health economics and outcomes research, and assist with future practice guideline development.
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Pilot study to evaluate computer-guided deep brain stimulation (DBS) programming designed to optimize stimulation settings using objective motion sensor-based motor assessments. ⋯ Motion sensor-based computer-guided DBS programming identified stimulation parameters that significantly improved tremor and bradykinesia with minimal clinician involvement. Automated motion sensor-based mapping is worthy of further investigation and may one day serve to extend programming to populations without access to specialized DBS centers.
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Observational Study
Trialing and Maintenance Dosing Using a Low-Dose Intrathecal Opioid Method for Chronic Nonmalignant Pain: A Prospective 36-Month Study.
To evaluate low-dose intrathecal opioid trialing and maintenance with regard to analgesia and psychometric functional capacity. ⋯ This study adds to the growing body of literature suggesting that low-dose intrathecal analgesia without oral opioid supplementation can be efficacious. It appears that this approach may achieve analgesia with lower doses in those with primary nociceptive pain type.
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A research study combining numerical simulation and animal-model experiments has been performed to assess the ability of simulation to accurately calculate temperatures within living tissue during the recharge of a neuromodulation system (Restore Ultra device, Medtronic Neuromodulation, Minneapolis, MN, USA). ⋯ It is shown that numerical simulation using the Pennes bioheat equation is capable of predicting temperature increases within living tissues when implanted heat-generating devices are in use. The device used in the present study does not give rise to temperatures which cause concern of thermal injury or safety. The study was performed for aligned antenna and implant.