Neuromodulation : journal of the International Neuromodulation Society
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This study aims to review some of the basic principles of extracellular electrical stimulation used in spinal cord stimulation therapy for intractable pain. ⋯ A better understanding of the interaction between electric fields and the targeted neural elements may guide the selection of stimulation parameters in contemporary neurostimulators and lead to continuing advances in engineering solutions for therapeutic spinal cord stimulation.
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Multicenter Study
The Italian experience with octopolar perc-paddle leads.
The aim of this study is to evaluate the efficacy of spinal cord stimulation using octopolar perc-paddle leads (S-Series, St. Jude Medical, St. Paul, MN, USA) introduced percutaneously with St. Jude Medical's Epiducer Lead Delivery System in patients suffering from low back and leg pain. ⋯ The possibility of using a percutaneous paddle lead, reducing the surgical aggressiveness but taking advantage of a different electric field and a better recruitment of the fibers of the lumbar region, has allowed pain therapists to be more effective in the treatment of these patients. The use of this device system suggests that the percutaneous paddle placement is safe and effective.
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This study aims to review the current state of spinal cord stimulation for the treatment of chronic pain associated with failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) and to describe intraspinal targets and stimulation parameters, patient selection, therapy cost-effectiveness, and strategies to improve outcomes. ⋯ Innovation in spinal cord stimulation therapy has intensified with numerous new technical capabilities, safety advances, and novel stimulation targets. This progress holds hope for the many sufferers of chronic pain.
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Spinal cord stimulation (SCS) has become an evidence-based treatment for a variety of chronic pain disorders. A key step in appropriate patient selection and long-term outcome predictability is a percutaneous screening trial of stimulation. Occasionally, a trial cannot be adequately completed with a percutaneous electrode. Rather than depriving this therapy from these patients, the authors have developed a program providing surgically implanted paddle-lead screening trials of SCS. ⋯ Surgically implanted paddle-lead screening trials of SCS can be used safely and effectively in those patients in which an adequate percutaneous-electrode trial cannot be completed. Results are similar to those seen with standard percutaneous screening trials. A systematic approach to surgical-paddle screening trials of SCS has not been previously reported.