Neuromodulation : journal of the International Neuromodulation Society
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Objective. To identify aspects of daily life that have been most affected by chronic low back pain among spinal cord stimulation (SCS) patients and to determine the relative contribution that improvement in each would make to patients' quality of life (QOL). Materials and Methods. ⋯ Patients with chronic low back pain seek improvement in multiple dimensions of QOL after SCS, particularly increased physical activity, social relations, work status, and mood. It is likely that patients' assessment of SCS "success" correlates highly with functional improvement. As such, an understanding of SCS therapeutic benefit and satisfaction requires that QOL be carefully assessed in future outcome trials.
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Objective. To investigate whether a simple static stiffness model adequately relates the angles and net joint torques (NJT) developed in the ankles (sagittal plane) and in the hips (frontal plane) following perturbations delivered in multiple directions to partially constrained subjects standing quietly. Materials and Methods. ⋯ Conclusions. The relationship between the ankle angles and NJT and hip angles and NJT following perturbed stance can be described as static stiffness. The implications for arm-free paraplegic standing are discussed and a new control scheme is proposed.
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Intrathecal drug delivery is a widely used and effective method of treatment for chronic intractable pain. Unfortunately all currently used agents can not provide adequate pain relief in all patients. A prospective study of neuroaxial methadone was performed in 24 patients, all of whom had failed treatment with multiple previous intrathecal drugs. ⋯ The final rates of methadone infusion were 2.2 times higher than preceding morphine rates. The only observed possible side effect of methadone was transient blurred vision in one patient. Methadone is a promising alternative neuroaxial agent in the treatment of chronic pain.
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Interstitial cystitis is the most disabling nonmalignant disorder seen by urologists. Chronic debilitating urinary bladder symptoms (severe pain and pelvic floor muscular dysfunction) often progress despite maximal medical attempts at management. Although the exact cause remains unknown, a neuropathic etiology has recently been suggested( 1,2). This case report describes the use of Selective Nerve Root Stimulation (SNRS) for the treatment of intractable pelvic pain and motor dysfunction in a patient with Interstitial cystitis (IC).
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Objective. The purpose of this study is to evaluate the effectiveness of modern spinal cord stimulation (SCS) for the treatment of failed back surgery syndrome (FBSS). Materials and Methods. ⋯ Conclusions. SCS is an effective treatment for chronic low back and lower extremity pain which is refractory to conservative therapy and which is not amenable to corrective anatomic surgery. Though our patient population is small, our results imply that the laminectomy-style electrodes in the thoracic region achieve better long-term effectiveness than percutaneous leads.