Neuromodulation : journal of the International Neuromodulation Society
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Study Design. This is a prospective study designed to identify psychological factors associated with response to spinal cord stimulation (SCS) trial. Summary of Background Data. ⋯ Conclusions. Patient mood state is an important predictor of trial outcome. Specific indicators of SCS trial outcome are the MMPI depression and mania subscale scores with successful trials being associated with individuals who are less depressed and have higher energy levels.
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Centers for Disease Control (CDC) data indicate that the incidence of tetanus in the United States is highest among the elderly. Conventional therapies for the control of accompanying generalized muscle spasms include large doses of oral or intravenous GABA agonists as antispasticity agents. ⋯ Accordingly, we report the first placement of a permanent implanted infusion pump for this disease. This modality offers advantage for continuous long-term titration of medication for spasms or rigidity control without the systemic sedative effects of conventional therapy.
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Objective. To evaluate the effectiveness of spinal cord stimulation using multiple independent programmable electrode selections compared to simple continuous stimulation. Design. ⋯ Conclusions. Continuous stimulation was not selected by any patient in favor of multi-stimulation or patient-controlled stimulation. This study indicates that in spinal cord stimulation the use of multiple electrodes together with advanced programmability increases paresthesia overlap, reduces pain scores, reduces revision rates, and improves patient satisfaction with spinal cord stimulation therapy.
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This paper is an overview of the results of computer modeling of spinal cord stimulation, started ten years ago at the University of Twente, The Netherlands. Results are given of the analysis of various geometrical factors, including spinal anatomy, which influence the effect of spinal cord stimulation on nerve fiber recruitment and paresthesia coverage. ⋯ Two new electrode types are presented: the narrow bi-/tripole and the transverse tripole. The latter also enables adjusting the body area affected with paresthesia by means of a dual channel pulse generator giving simultaneous pulses, thereby limiting surgical interventions for electrode repositioning.
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Study Design. This is a retrospective study on 102 patients subjected to implantation of a spinal cord stimulation system for nonmalignant chronic pain management. The study was conducted through an extensive questionnaire and telephone interviews by a neutral third party. ⋯ Psychological screening contributed to the success of the procedure. Conclusions. With proper medical and psychological screening and with demonstrated initial pain relief, spinal cord stimulation remains an effective modality in the long-term management of severe chronic pain.