Neuromodulation : journal of the International Neuromodulation Society
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Ziconotide is a reversible blocker of the N-type neuronal voltage-sensitive calcium channels with analgesic effects. The main adverse effects of ziconotide are ataxia, dizziness, gait disorder, confusion, hallucinations, and gastrointestinal symptoms. ⋯ A psychiatric disorder with cholinergic-noradrenergic system impairment could increase some side-effects of treatment with N-type calcium channel blockers.
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Comparative Study
Awake vs. asleep placement of spinal cord stimulators: a cohort analysis of complications associated with placement.
Patients will typically undergo awake surgery for permanent implantation of spinal cord stimulation (SCS) in an attempt to optimize electrode placement using patient feedback about the distribution of stimulation-induced paresthesia. The present study compared efficacy of first-time electrode placement under awake conditions with that of neurophysiologically guided placement under general anesthesia. ⋯ Non-awake surgery is associated with fewer failure rates and therefore fewer re-operations, making it a viable alternative. Any benefits of awake implantation should carefully be considered in the future.
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Autologous iliac crest bone graft (ICBG) harvest is a common procedure performed at the time of many spinal surgical procedures and associated with morbidity incurred at the harvest site, the most troublesome being chronic donor site pain. ⋯ Peripheral nerve field stimulation offers an alternative treatment option for select patients with chronic hip pain after ICBG harvest.