Neuromodulation : journal of the International Neuromodulation Society
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Objectives. Vertebral fractures are the most common consequences of severe osteoporosis. The chronic pain from collapse of osteoporotic vertebrae affects quality of life (QoL) and autonomy of patients. The management of pain with oral or transdermal opiates can cause severe side-effects. ⋯ The mean morphine dose during the spinal trial was 11.28 mg/day, 7.92 mg/day at pump implantation, and 16.32 mg/day at one-year follow-up. Conclusions. Our results show that intrathecal administration of morphine efficiently relieves the symptoms of pain and improves QoL. Continuous intrathecal administration of morphine appears to be an alternative therapy to conventional analgesic drug delivery and has advantages in those patients who have severe side-effects with systemic administration of analgesics.
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Objective. When using spinal cord stimulation (SCS) for chronic pain management, precise longitudinal positioning of the cathode is crucial to generate an electrical field capable of targeting the neural elements involved in pain relief. Presently used methods have a poor spatial resolution and lack postoperative flexibility needed for fine tuning and reprogramming the stimulation field after lead displacement or changes in pain pattern. We describe in this article a new method, "electrical field steering," to control paresthesia in SCS. ⋯ Conclusions. By means of cathodal steering on a longitudinal contact array, the group of excited DC and DR fibers, and thus paresthesia coverage, can be controlled when using SCS. With widely spaced contacts, superposition of the electrical field from each steering contact is limited. To precisely control segmental paresthesia (DR stimulation), a small contact spacing is necessary.