Neuromodulation : journal of the International Neuromodulation Society
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The objective of this study was to examine the programming strategies used in patients with intractable low-back pain treated with epidural spinal cord stimulation (SCS) utilizing paddle electrodes and a radio frequency (RF) stimulator. Programming strategies were examined in a group of patients implanted with a 16-contact paddle electrode and a dual channel RF receiver to treat chronic low-back pain. Baseline data included previous surgical history information, leg and low back pain severity and characteristics, and routine demographic information. ⋯ The system must provide the capability to redirect the current electronically over at least two segments of the spinal canal, to electronically steer the current in a medio-lateral direction, and to activate multiple electrical contacts simultaneously. The willingness and ability to provide extensive reprogramming in the long term follow-up is also of the utmost importance. Pain and its treatment with SCS is a dynamic process.
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The objective of this study was to follow up patients considered for spinal cord stimulation and assess outcomes and patient selection factors associated with outcome. A retrospective study of patients considered for spinal cord stimulation was performed. This included three groups: A) those who did not have a temporary trial of stimulation, B) those who did not go on to have long-term stimulation after a trial, and C) those who did go on to have long-term stimulation after a trial. ⋯ We conclude that spinal cord stimulation is an efficacious therapy which is not associated with serious side effects. There is some reduction in therapeutic efficacy over time. Patients deteriorate without treatment.
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The implantation of a drug (opioid) infusion system catheter at the level of the cisterna magna, connected to an implanted programmable pump (Synchromed pump, 8611-H, Medtronic, Minneapolis, MN) is the procedure we use most commonly for the treatment of craniofacial and upper cervical pain. Our implantation technique, which we consider simple and easy to perform, is discussed in this article. Our results have been extremely encouraging, without untoward effects occurring. Adverse effects are prevented by the close proximity of the catheter tip to the pain receptors.