Neuromodulation : journal of the International Neuromodulation Society
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Objective. Since 1996 we have placed temporary catheters at the cervical nerve roots in chronic pain patients for the treatment of radiculopathy and complex regional pain syndrome. We investigated the possibility of placing electrodes both at the cervical spinal nerve and dorsal root ganglion for the purpose of neuromodulation. ⋯ Conclusions. In human cadavers, a percutaneous technique was successful in the placement of neurostimulator electrodes at the cervical and upper thoracic nerve roots using a novel trans-spinal approach. New smaller electrode systems that can be placed in a transforaminal position safely may be needed.
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Spinal cord stimulation has become an accepted technique used in the management of chronic neuropathic pain syndromes. However, a number of problematic questions remain unanswered. This introduction states some of these problems and concentrates on the problem of whether low back pain can be relieved by stimulation. This paper introduces subsequent contributions to this symposium, which offer some interesting new techniques, and attempts to answer some of the problems presented.
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Objective. To present a novel approach for treatment of intractable occipital neuralgia using percutaneous peripheral nerve electrostimulation techniques. Methods. ⋯ The 13th patient (first in the series) was subsequently explanted following symptom resolution. Conclusions. In patients with medically intractable occipital neuralgia, peripheral nerve electrostimulation subcutaneously at the level of C1 appears to be a reasonable alternative to more invasive surgical procedures following failure of more conservative therapies.
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The following account discusses the possible mechanisms by which spinal cord stimulation can control symptoms of Complex Regional Pain Syndromes. A review of the literature with a methodology for its incorporation in a treatment algorithm and associated technical aspects is suggested.