Neuromodulation : journal of the International Neuromodulation Society
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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.
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Editorial Historical Article
Progress in the technology of neuromodulation: the emperor's new clothes?
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Randomized Controlled Trial Multicenter Study
Analgesic efficacy of high-frequency spinal cord stimulation: a randomized double-blind placebo-controlled study.
Spinal cord stimulation is a recognized treatment of chronic neuropathic and vascular pain. Recent data suggest that the use of very high-frequency (HF) stimulation modes does produce analgesia without paresthesia. ⋯ This is the first randomized double-blind study on SCS. HFSCS was equivalent to sham for the primary outcome (improvement of PGIC) as well as for both the secondary outcomes (VAS and EQ-5D index). There was a highly statistically significant "period effect" (p = 0.006) with improved PGIC scores in the first study period regardless of the treatment. The same trend was seen for VAS and EQ-5D. It appears that the effect of HFSCS and sham is equal and only the order in the sequence, not the nature of the treatment, seems to dictate the effect.