Neuromodulation : journal of the International Neuromodulation Society
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Multicenter Study
Increased pain catastrophizing associated with lower pain relief during spinal cord stimulation: results from a large post-market study.
Pain catastrophizing is a negative cognitive distortion to actual or anticipated pain. Our aim was to determine if greater catastrophizing has a deleterious relationship with pain intensity and efficacy outcomes in patients receiving SCS. ⋯ Our results indicate that patients with greater catastrophizing, post-implant, were more likely to report higher pain intensity and lower pain relief, quality of life and satisfaction with SCS. These results indicate that associations between pain intensity and pain-related mental health may contribute to influence the overall efficacy of SCS.
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Randomized Controlled Trial Multicenter Study
Analysis of adverse events in the management of chronic migraine by peripheral nerve stimulation.
In this study, we analyze device- and procedure-related adverse events (AEs) from a recent prospective, multicenter, double-blinded controlled study that utilized peripheral nerve stimulation (PNS) of occipital nerves for management of chronic migraine. ⋯ Implantation of the IPG closer to the lead location was associated with reduced AEs. PNS is a relatively new procedure, and the skill and precision in performing these procedures improves with experience. Our results demonstrate that as the implanter gains more experience with these procedures, a significant reduction in device- and procedure-related AEs may be expected.
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Multicenter Study
Use of a newly developed delivery device for percutaneous introduction of multiple lead configurations for spinal cord stimulation.
The Epiducer lead delivery system is a novel lead delivery device that can be used to percutaneously implant S-Series paddle leads (St. Jude Medical, Plano, TX, USA) as well as multiple percutaneous leads obviating the need for laminectomy and/or multiple needle sticks, respectively. This study evaluates the safety and usage of the Epiducer lead delivery system. ⋯ Results suggest that the Epiducer delivery system allows for the safe and successful percutaneous implantation of paddle leads and/or multiple lead configurations. Furthermore, physicians are satisfied with the Epiducer delivery system.
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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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Review Multicenter Study
Effectiveness of cervical spinal cord stimulation for the management of chronic pain.
Scientific evidence supports spinal cord stimulation (SCS) as a cost-effective treatment option that, for many disease states, should be employed earlier in the treatment continuum. Reimbursement for SCS in the cervical spine has recently been challenged based on supposed lack of clinical literature. To refute this assumption, we analyzed data from an international registry to support the use of cervical SCS. ⋯ The results suggest that the use of SCS in the cervical spine is a medically effective method of pain management that satisfies and improves the QoL of most patients. The use of SCS can reduce the high cost of direct medical treatment of pain, as well as increasing the productivity of patients, and therefore should be reimbursed in appropriately selected patients.