Neuromodulation : journal of the International Neuromodulation Society
-
The purpose of the study was to determine if functional electrical stimulation of abdominal muscles (FESAM) could maintain pulmonary ventilation at acceptable levels in individuals with spinal cord injury (SCI) who are unable to breathe spontaneously. This is the first published investigation of this technique in this subject population. This case series study included three individuals with SCI; two were on mechanical ventilation (MV), and one used mechanical ventilation and also had an implanted phrenic nerve stimulator (PNS). ⋯ When oxygenation measured with pulse oximetry dropped to 92% saturation, FESAM was discontinued, and MV or PNS was resumed. This is the first report of achieving successful ventilation in individuals with SCI who have zero tidal volume using FESAM. These preliminary results indicate the clinical potential of FESAM as an additional tool in the armamentarium of supported ventilation.
-
The objective of this study was to examine the programming strategies used in patients with intractable low-back pain treated with epidural spinal cord stimulation (SCS) utilizing paddle electrodes and a radio frequency (RF) stimulator. Programming strategies were examined in a group of patients implanted with a 16-contact paddle electrode and a dual channel RF receiver to treat chronic low-back pain. Baseline data included previous surgical history information, leg and low back pain severity and characteristics, and routine demographic information. ⋯ The system must provide the capability to redirect the current electronically over at least two segments of the spinal canal, to electronically steer the current in a medio-lateral direction, and to activate multiple electrical contacts simultaneously. The willingness and ability to provide extensive reprogramming in the long term follow-up is also of the utmost importance. Pain and its treatment with SCS is a dynamic process.
-
The objective of this study was to follow up patients considered for spinal cord stimulation and assess outcomes and patient selection factors associated with outcome. A retrospective study of patients considered for spinal cord stimulation was performed. This included three groups: A) those who did not have a temporary trial of stimulation, B) those who did not go on to have long-term stimulation after a trial, and C) those who did go on to have long-term stimulation after a trial. ⋯ We conclude that spinal cord stimulation is an efficacious therapy which is not associated with serious side effects. There is some reduction in therapeutic efficacy over time. Patients deteriorate without treatment.
-
Intrathecal drug therapy has become an indispensable tool in the treatment of many different neurologic disorders. It allows targeted infusion of small quantities of drugs, thereby increasing effectiveness while reducing unwanted side effects typically seen in oral drug administration. The following paper discusses the current technology in constant rate intrathecal drug-infusion delivery systems and the effect of pressure and temperature on flow rate accuracy.