Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial Multicenter Study
Comparing the Efficacy of Dorsal Root Ganglion Stimulation With Conventional Medical Management in Patients With Chronic Postsurgical Inguinal Pain: Post Hoc Analyzed Results of the SMASHING Study.
Approximately 10% of patients who undergo inguinal hernia repair or Pfannenstiel incision develop chronic (> three months) postsurgical inguinal pain (PSIP). If medication or peripheral nerve blocks fail, a neurectomy is the treatment of choice. However, some patients do not respond to this treatment. In such cases, stimulation of the dorsal root ganglion (DRG) appears to significantly reduce chronic PSIP in selected patients. ⋯ The Clinicaltrials.gov registration number for the study is NCT02349659.
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Randomized Controlled Trial
Epidural Laterality and Pain Relief With Burst Spinal Cord Stimulation.
Burst spinal cord stimulation (SCS) can achieve excellent clinical reduction of pain, alongside improvements in function, quality of life, and related outcomes. Good outcomes likely depend on good lead placement, thereby enabling recruitment of the relevant neural targets. Several competing approaches exist for lead implantation, such as the use of single vs bilateral leads and leads lateralized vs placed at midline. The objective of this study was to examine the relationship between paresthesia locations and pain relief with burst SCS in a prospective double-blind crossover design. ⋯ When burst stimulation is delivered to spinal targets that can generate paresthesias contralateral to the side of worst pain, suboptimal therapy is achieved. Thus, attention to laterality and pain coverage is critical for successful therapy, and it may be important to carefully consider lead implantation techniques.
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Randomized Controlled Trial Multicenter Study
Multiphase Spinal Cord Stimulation in Participants With Chronic Back or Leg Pain: Results of the BENEFIT-02 Randomized Clinical Trial.
This study aimed to assess the safety and effectiveness of a new charge-distributed multiphase stimulation paradigm during an extended spinal cord stimulation (SCS) trial. ⋯ The Clinicaltrials.gov registration number for the study is NCT03594266.
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Randomized Controlled Trial Multicenter Study
Treatment of Refractory Low Back Pain Using Passive Recharge Burst in Patients Without Options for Corrective Surgery: Findings and Results From the DISTINCT Study, a Prospective Randomized Multicenter Controlled Trial.
Spinal cord stimulation (SCS) is effective for relieving chronic intractable pain conditions. The Dorsal spInal cord STImulatioN vs mediCal management for the Treatment of low back pain study evaluates the effectiveness of SCS compared with conventional medical management (CMM) in the treatment of chronic low back pain in patients who had not undergone and were not candidates for lumbar spine surgery. ⋯ The Clinicaltrials.gov registration number for the study is NCT04479787.
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Randomized Controlled Trial
A Prospective, Randomized Single-Blind Crossover Study Comparing High-Frequency 10,000 Hz and Burst Spinal Cord Stimulation.
Although both high-frequency and burst spinal cord stimulation (SCS) have shown improved efficacy and patient satisfaction compared with conventional tonic stimulation, there are limited data directly comparing the two. This study aimed to compare both high-frequency 10,000 Hz and burst SCS in the same patients in terms of pain relief and satisfaction in those with axial back pain with or without leg pain. ⋯ There were no observed differences in VAS pain score decrease when comparing burst and high-frequency 10,000 Hz SCS programming therapies. Patient preference followed an order effect, favoring the first programming therapy in the trial sequence.