Neuromodulation : journal of the International Neuromodulation Society
-
The objective of this retrospective study was to study the frequency of intraoperative neuromonitoring (IONM) alerts during the spinal cord stimulator (SCS) placement surgery, postoperative neurological complications and effectiveness of Somatosensory evoked potential (SSEP) and electromyography (EMG) methods to determine laterality of the SCS lead placement. ⋯ IONM is an effective tool in detecting potential neurological event and facilitating lead placement and potentially avoiding revision surgery.
-
Spinal cord stimulation (SCS) revision surgery remains common, with a negative impact on cost-effectiveness and outcomes. The primary goal of this report was to retrospectively study the need for revision surgery in a cohort of complex regional pain syndrome type I (CRPS-1) patients with newly implanted cervical surgical paddle leads, focusing on a method of implantation to reduce the need for revision surgery. ⋯ This study is the first to report on: 1) cervical electrode implantation with no anchoring; and 2) cervical paddle lead implantation (including three-column paddles) performed under conscious sedation. The specific method of nonanchoring of the paddle implants under conscious sedation may have contributed to low electrode lead revision rates.
-
This study is an evaluation of whether motor provocation compared to mixed sensory/motor provocation for tined lead placement affects its efficacy with quality of life measurements and Likert patient satisfaction. ⋯ Women with mixed sensory/motor provocation tined lead placement incurred statistically significant longer operating room times and an increased number of annual reprogramming sessions. Singular motor provocation tined lead placement may, in fact, improve outcomes by significantly decreasing operating room time, improving patient satisfaction, and decreasing mean yearly reprogramming sessions, compared to mixed sensory/motor tined lead placement.
-
We proposed a novel method of chronic electroacupuncture (EA) using implanted electrodes for the treatment of chronic chemotherapy-induced nausea and vomiting (CINV). We aimed to establish a rodent model of delayed emesis and explore EA effects on kaolin intake. ⋯ EA with parameters of 20 Hz, 0.3 msec for three hours on both PC6 and ST36 acupoints was found to be the best in reducing kaolin intake. Chronic EA with appropriate parameters is effective in reducing pica in a rodent model of CINV.
-
Dynamic Detection of Spinal Cord Position During Postural Changes Using Near-Infrared Reflectometry.
Motion of the spinal cord relative to a spinal cord stimulator epidural electrode array can cause suboptimal stimulation: either noxious, inefficient, or insufficient. Adaptive stimulation attempts to mitigate these effects by modulating stimulation parameters in a position-dependent fashion. Near-infrared (NIR) reflectometry is demonstrated to provide real-time direct measurement of spinal cord position at the site of stimulation, which can facilitate closed-loop adaptive stimulation during static and dynamic motion states. ⋯ Spinal cord position during dynamic motion has been shown to differ from static predictions due to additional influences such as centripetal force. These findings underscore limitations in extrapolating spinal cord position from surrogates such as body position or body acceleration at sites remote from the stimulating electrodes. NIR reflectometry offers a real-time direct measure of spinal cord position in both static and dynamic motion states, which may facilitate closed-loop adaptive stimulation applications.