Neuromodulation : journal of the International Neuromodulation Society
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The failed back surgery syndrome (FBSS) is the most common chronic pain syndrome. Whereas it is relatively easy to achieve pain relief in the lower limbs of FBSS patients with spinal cord stimulation (SCS), it is difficult to manage low back pain with SCS. The performance of a paddle-shaped SCS lead that can be inserted surgically as well as percutaneously (a hybrid lead) was evaluated in a prospective study on the relief of low back pain and leg pain in patients with FBSS. ⋯ SCS with a hybrid lead in subjects with FBSS is safe, and causes significant pain relief in both the low back and the lower limbs.
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This study compares the effects of constant current (CC) and constant voltage (CV) spinal cord stimulation (SCS) at various frequencies and intensities on standard nociceptive measurements in rats, the visceromotor reflex (VMR) and neuronal activity, during noxious visceral and somatic stimuli. ⋯ Although high-frequency CC- and CV-SCS may be more useful for the management of somatic pain, CC-SCS may be more effective for treating complex pain systems like visceral hypersensitivity.
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Complications associated with intrathecal pumps may be linked to the surgical procedure, the implanted device, or the medication itself. ⋯ Inadvertent injection into the subcutaneous pocket rather than the reservoir is rare but very dangerous as the drug cannot be retrieved and massive doses are involved. Signs and symptoms of systemic overdose with drugs commonly used in implanted drugs delivery system should be well known to ensure early diagnosis and treatment.
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In able-bodied participants, it is possible to induce a sense of perceptual embodiment in an artificial hand using a visual-tactile illusion. In amputee patients, electrical stimulation of sensory afferents using transcutaneous electrical nerve stimulation (TENS) has been shown to generate somatic sensations in an amputee's phantom limb(s). However, the effects of TENS on the perceptual embodiment of an artificial limb are not known. Our objective was to investigate the effects of TENS on the perceptual embodiment of an artificial limb in fully intact able-bodied participants. ⋯ Our findings provide initial evidence that TENS paresthesia can be projected into an artificial limb, and this can enhance the sense of perceptual embodiment of an artificial hand. Further exploratory studies involving an amputee population are warranted.