Neuromodulation : journal of the International Neuromodulation Society
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Review Case Reports
Intrapleural migration of a spinal catheter in a patient with arachnoiditis and extensive epidural scarring after tethered cord release: a case report and review of literature.
The objective of this study was to report a case of new onset refractory pain from intrapleural migration of a spinal catheter five months after the implantation of an intrathecal drug delivery system (IDDS). ⋯ Physicians and nursing staff that place and manage an IDDS should be aware of this complication.
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We reviewed the clinical applications, academic communications, and specialized training required for deep brain stimulation (DBS) in China. Current problems and possible solutions also were discussed. ⋯ DBS has evolved significantly during the past decade in China. There are still several problems. The advent of Chinese homemade DBS hardware, multidisciplinary cooperation, and the establishment of guidelines and regulations for DBS will improve the application of this surgical treatment in China.
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Patients with extensive surgery in the lumbar and thoracic spine are often not considered for neurostimulation due to the inability to perform a conventional spinal cord stimulation (SCS) trial. We are presenting six such patients in which spinal-peripheral neurostimulation (SPN) was used via a caudal approach. ⋯ SPN with a caudal lead appears to be a viable option for SCS trial in patients with no possibilities for conventional trial lead placement.
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Review
Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis.
Gastric electrical stimulation (GES) has been introduced for treating gastric motility disorders, such as gastroparesis, and obesity. A special method of GES using high frequency-short pulses, called Enterra® Therapy, has been clinically applied to treat nausea and vomiting in patients with gastroparesis. However, its mechanisms are not well understood. ⋯ GES with high frequency-short pulses effectively reduces nausea and vomiting in patients with gastroparesis. This antiemetic effect could be mediated via enteric, autonomic, and/or central neural mechanisms. Further systematic and controlled studies are needed to improve the efficacy of Enterra Therapy and to understand its mechanisms of action.
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Review Historical Article
A history of intraspinal analgesia, a small and personal journey.
There is a large and robust literature on the spinal use of opioids and non-opioids alike, but unless one is my age and older, very few persons know how we got here. This small history offering tells us how we got to where we are today regarding the science, clinical uses, and management of intraspinal analgesia. ⋯ The history of the use of intraspinal analgesia is rich and guides us to advance the science and clinical use of intraspinal analgesia without reinventing the wheel.