Neuromodulation : journal of the International Neuromodulation Society
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Spinal cord stimulator lead migration is a common problem. Anchor design may be a factor in its prevention. We have undertaken a cadaveric and in vitro comparative investigation of the force required to cause lead migration with a variety of anchor types. ⋯ The titanium anchor prevents simulated lead movement at greater forces that the silastic anchors with a variety of leads. For silastic anchors, movement occurred at median force below that simulated with spinal movement; for the titanium anchor, movement occurred at a median force above that simulated with spinal movement. Further in vivo investigations are warranted to assess the potential of titanium anchoring to significantly reduce spinal cord stimulator lead migration.
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Objectives. This study aims to demonstrate the utility of spinal cord stimulation in a neuropathic pain syndrome and overall decline in health and functional independence following elapid envenomation in a morbidly obese, insulin-dependent diabetic. Materials and Methods. A two-lead, 16-electrode constant-current, independently controlled system is placed in the mid-cervical spine. Results. Noted were a improvement in overall health status with better glycemic control and return to work status in response to adequate pain control. Conclusions. The case serves as a model for other orphan pain cases with a seemingly esoteric etiology and adds to the existing body of literature that spinal cord stimulation and neuromodulation, in general, has a wide-ranging applicability peripheral neuropathic pain syndromes.
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Brain-gut axis represents a complex reflex circuit that integrates the communication between cortex and the digestive system. Disturbances of the neuromodulatory processes in the brain-gut axis generate functional digestive disorders mainly centered on the pain symptoms and motility disorders. ⋯ The efficacy of the methods using electrostimulation is dependent on the parameters of the physical system used: amplitude, frequency, burst time of the electrical current and also the positioning of the electrodes. While pharmacological interventions are largely used at the moment, neuromodulatory interventions involving electrical stimulation showed clinical efficacy in research trials and have promise.
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Intrathecal drug delivery device infection with Mycobacterium fortuitum has not been reported previously. We report a case of an implanted baclofen pump infection and associated mycobacterium meningitis due to Mycobacterium fortuitum. The entire pump system was removed and the patient was treated successfully with a prolonged regimen of antibiotics.