Neuromodulation : journal of the International Neuromodulation Society
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Introduction. Spinal cord stimulation (SCS) is an effective treatment option for neuropathic pain. However, because of the obvious procedural issues, SCS is unable to reach certain areas, such as the face, thorax, coccyx, the cervico-dorsal and lumbar areas, and the sacral, abdominal, and inguinal regions. On the other hand, these areas are easily reached by subcutaneous field stimulation. ⋯ As a result of pain reduction, the patients' quality of life improved. There were no adverse events reported except for early electrode array displacement in two of our patients. Conclusion. When SCS is not appropriate for certain neuropathic pain syndromes, subcutaneous field stimulation may be used with some degree of efficacy.
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A synergistic investigation involving both experiment and numerical simulation was performed in vitro to determine the heat flow from rechargeable neuromodulation systems into surrounding media. Each system consists of an implant and an external recharging antenna, and the heat flows of each of these components were determined separately. Three systems, each produced by a different medical device firm, were evaluated. ⋯ In general, replicate data runs for each system and each component were in satisfactory agreement. The different samples of the MDT system showed only minor deviations with regard to heat flow. The deviations among the different samples of both ANS and BSC were larger than those evidenced for MDT.
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The objective of this paper is to educate physicians who implant spinal cord stimulators in current surgical techniques. Many implanters have not gone through formal surgical residencies and learn their surgical techniques during a one year Fellowship or from proctoring experience. ⋯ In addition, a more detailed presentation is made at the end of this paper on a proposed simple one-incision surgical technique for implantation of small internal pulse generators. This is the first publication in the literature describing such a technique and may be useful for less-experienced implanters, as well as conferring potential advantages in surgical technique.
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Objective. This study aims to investigate the movements of hyolaryngeal structures during the surface electrical stimulation of suprahyoid muscles and to compare these with movements during liquid swallowing. Materials and methods. Twelve volunteers without dysphagia participated in this study. Volunteers swallowed 5 mL of diluted barium liquid, which was recorded videofluoroscopically. ⋯ Trajectories of the hyoid and larynx during electrical stimulation were smaller than but similar to those that occurred during liquid swallowing. Conclusion. This study suggests that surface electrical stimulation of suprahyoid muscles causes the elevation and anterior excursion of hyolaryngeal structures, as is observed during normal physiologic swallowing, although the movements involved were smaller. Further studies are required to determine the effect of synchronized electrical stimulation on dysphagia patients with reduced laryngeal elevation to allow the development of a swallow-assisting neural orthosis.