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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We report a case of spinal cord stimulation (neurostimulation) as treatment of angina pectoris pain in a patient with an implantable cardioverter-defibrillator. The precautions taken to avoid inhibition of the demand pace function and avoid activation of the shock function by the neurostimulation are discussed.
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Intrathecal drug therapy has become an indispensable tool in the treatment of many different neurologic disorders. It allows targeted infusion of small quantities of drugs, thereby increasing effectiveness while reducing unwanted side effects typically seen in oral drug administration. The following paper discusses the current technology in constant rate intrathecal drug-infusion delivery systems and the effect of pressure and temperature on flow rate accuracy.