Neuromodulation : journal of the International Neuromodulation Society
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Objective. This study aims to evaluate the usefulness of peripheral nerve stimulation as a treatment option for patients with chronic low back pain. Materials and Methods. More than 12 months, we collected data on consecutive patients who had successful trials and were subsequently implanted with octrode percutaneous leads placed subcutaneously within the major area of pain. Eleven patients met diagnostic criteria for failed back surgery syndrome. ⋯ Pain relief was highly correlated with reduced analgesia and patient satisfaction. No complications were reported. Conclusion. This study demonstrates a treatment option that is safe, nonpharmacologic, reversible, and effective for patients with chronic low back pain that have exhausted other treatment options.
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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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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.
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Objective. This descriptive study compares outcome measures of a computerized assessment of pain, emotional distress, and quality of life between chronic noncancer pain patients who have received an implantable device (spinal cord stimulator or intrathecal pump; N = 143) and those who have not received a device (N = 130). Methods. Each patient marked the location of their pain on a body diagram and rated pain intensity, emotional distress, and impact of their pain on mood, sleep, and quality of life using a computerized pain assessment program. An electronic version of the Hospital Anxiety and Depression Scale (HADS) also was administered. ⋯ The patients with implantable devices also scored lower on the HADS Depression Subscale. Conclusion. The results suggest that although patients with an implantable device seem to have more pathology and greater disability, they report less emotional distress and improved quality of life compared with patients with chronic pain without an implantable device. Future controlled trials are needed to establish the role that an implantable device plays in improving mood and quality of life.