Neuromodulation : journal of the International Neuromodulation Society
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To provide a general control system framework for neuromodulation, its practical challenges, and historical underpinnings in cardiac rhythm devices, and to illustrate the potential of closed-loop techniques in neuromodulation with a case study using an adaptive neural stimulation system that integrates sensing, actuation, and state estimation for the treatment of chronic pain through spinal cord stimulation. ⋯ Technological advances in neuromodulation using such a control framework have the potential to improve neurologic therapies. Future opportunities for extending the role of these systems are briefly discussed.
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Spinal cord stimulation (SCS) is expected to have analgesic effects in patients with neuropathic pain, ischemic pain, or mixed pain. The type of leg pain caused by lumbar spinal stenosis (LSS) is considered as mixed pain, which is expected to respond to SCS. However, there is no established view on the usefulness of SCS in the management of this type of pain. Therefore, we aimed at evaluating the efficacy of SCS against leg pain associated with LSS. ⋯ SCS seemed to be effective against leg pain associated with LSS. Thus, SCS should be actively adopted in indicated patients as a method of treatment intermediate between conservative therapy and surgical therapy.