Neuromodulation : journal of the International Neuromodulation Society
-
The objective of this study is to present a novel surgical technique for safe placement of paddle-type spinal cord stimulation (SCS) electrode in the presence of epidural scar tissue. ⋯ SCS is a widely accepted treatment modality for chronic neuropathic pain. Placement of paddle electrode can be challenging, usually because of the presence of epidural scar tissue. There have been reported cases of spinal cord injury related to paddle electrode placement. We present a novel technique that allows for safe placement of a paddle-type SCS electrode in more challenging surgical circumstances, including the presence of epidural scar tissue.
-
Randomized Controlled Trial
60-Hz frequency effect on gait in Parkinson's disease with subthalamic nucleus deep brain stimulation.
Gait dysfunction is common in advancing Parkinson's disease and has a disappointing response to dopamine replacement and subthalamic nucleus deep brain stimulation programming parameters. Low-frequency stimulation, less than 130 Hz in combination with increased voltage, has been shown to decrease freezing episodes and number of steps with little impact on overall performance measured by the Unified Parkinson's Disease Rating Scale. This was in the setting of delivering the same total energy, which required both a change in voltage and frequency. We wanted to determine if the benefit came from low frequency alone. ⋯ We were unable to demonstrate improved gait with lower frequency stimulation as suggested by prior studies. This may have been because of the decreased energy delivered from the lower frequency and unchanged voltage.
-
Case Reports
Percutaneous peripheral nerve stimulation for chronic pain in subacromial impingement syndrome: a case series.
The objective of this study was to determine the effect of peripheral nerve stimulation (PNS) on pain reduction for those with refractory subacromial impingement syndrome (SIS) and to evaluate the association with reduced disability, impairment, and safety. Our hypotheses are that PNS will be associated with a reduction in pain, impairment and disability, and improvement in quality of life while demonstrating safety. ⋯ Intramuscular PNS for chronic shoulder pain due to SIS is a safe treatment associated with pain reduction, lower pain interference with activities of daily living, reduced disability, and improved shoulder abduction. Pain reduction is maintained for at least 12 weeks after treatment.