Pain practice : the official journal of World Institute of Pain
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Multicenter Study
10 kHz Spinal Cord Stimulation (SCS) for the Treatment of Chronic Peripheral Polyneuropathy (PPN): 12-month Results from Prospective Open-Label Pilot Study.
The goal of this study was to demonstrate that the paresthesia-independent 10 kHz spinal cord stimulation (SCS) can provide long-term pain relief in patients with peripheral polyneuropathy (PPN). Clinically diagnosed subjects with PPN refractory to conventional medical management were enrolled in this prospective, multicenter study between November 2015 and August 2016, after institutional review board approval and patient informed consent were obtained. ⋯ Findings from this study suggest that 10 kHz SCS may provide sustained pain relief and disability improvements in patients suffering from PPN.
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Observational Study
The Durability of Minimally Invasive Lumbar Decompression (mild® ) Procedure in Patients with Symptomatic Lumbar Spinal Stenosis: Long Term Follow-Up.
Minimally invasive lumbar decompression (mild® ) has been shown to be safe and effective for the treatment of lumbar spinal stenosis patients with hypertrophic ligamentum flavum as a contributing factor. This study examines the long-term durability of the mild procedure through 5-year follow-up. Pain relief and opioid medications utilization during 12-month follow-up were also assessed. ⋯ Based on our analysis, the mild procedure is durable over 5 years and may allow elderly patients with symptomatic lumbar spinal stenosis to avoid lumbar decompression surgery while providing significant symptomatic relief.
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Patients fitted with a neurostimulator face a greater need to undergo magnetic resonance imaging (MRI) scans. Given the lack of literature in this regard, this study aims to review our experience with MRI examinations on patients implanted with a dorsal root ganglion stimulation (DRG-S) system and their potential adverse events. ⋯ Necessary MRI examinations in patients with DRG-S systems are rarely covered by the European CE/US Food and Drug Administration (CE/FDA) approval. Although the manufacturer recommendations are against the use of MRI in patients with implanted DRG-S in certain conditions, we performed these scans without causing injury to the patient or damaging the device. Given that data on safety are limited, MRIs should be conducted study related. We provide recommendations for the procedure that should be followed when an MRI is needed urgently.
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The objective of this study was to assess the effectiveness of a low-dose intravenous S-ketamine treatment on refractory pain in patients with Complex Regional Pain Syndrome (CRPS). ⋯ In a group of patients with CRPS with refractory pain, low-dose intravenous S-ketamine treatment resulted in effective pain relief during infusion. Although a significant proportion of initial responders became nonresponders at follow-up, half of the patients were still a responder at ~ 4 weeks postinfusion. Further research is needed to investigate mechanisms responsible for pain relief by S-ketamine infusions and to ascertain possible predictors of response to the treatment.
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Central post-stroke pain (CPSP) has a detrimental effect on the quality of life of post-stroke patients. However, no definitive and effective method has been established yet for the treatment of CPSP. ⋯ Our study provides preliminary data suggesting that PNB could be an effective and feasible method to treat CPSP.