Neuromodulation : journal of the International Neuromodulation Society
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During the last decade, the complementary value of real-world data (through registries or medical records) and data from randomized clinical trials has been recognized as increasingly important. In the field of neuromodulation, only a few industry-independent nationwide neuromodulation registries are available. The interest in creating a European registry has increased but without a successful result. The goal of this online survey is to gain further insights into the need for and burden of a European registry for neuromodulation. ⋯ More than 90% of the respondents believed that a European registry for neuromodulation is needed, mainly to obtain real-world (big) data about the effectiveness and safety of this therapy. This survey clearly pointed to the need for a European registry for which it seems key to ensure financial and logistical support, in addition to in-depth legal guidance in developing this registry.
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Review Meta Analysis
Noninfectious Complications of Dorsal Root Ganglion Stimulation: A Systematic Review and Meta-Analysis.
Dorsal root ganglion stimulation (DRGS) has emerged as a promising treatment for chronic neuropathic pain. However, its safety and complications are not fully understood, with existing literature primarily based on case reports, observational studies, and data base analyses. This systematic review and meta-analysis aims to assess the prevalence of noninfectious complications associated with DRGS, focusing on the trial phase, postimplantation period, and revisions, while identifying risk factors for these outcomes. ⋯ DRGS shows a safety profile comparable to that of spinal cord stimulation, with similar rates of lead migrations and fractures. Improvements in surgical techniques, technology, and clinician expertise are expected to reduce complications. Future research should standardize reporting practices and detail implantation techniques to better understand and refine best practices in DRGS implantation.
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Standard anterograde placement of a surgical paddle lead (SPL) for spinal cord stimulation (SCS) can be challenging in patients with scarring from prior spine surgery, instrumentation obstructing the targeted level, or severe stenosis below the targeted level. One potential alternative is retrograde (caudal) insertion by performing laminotomies cephalad to the targeted levels. The literature is limited to only a small number of individual cases describing this technique. In this report, the authors present their experience over the last ten years of the retrograde insertion of SPLs for SCS. ⋯ The retrograde insertion of SPLs is a low-risk and feasible procedure that can be performed with minimal risk of lead migration, fracture, or deep surgical site infection. The retrograde strategy can be used in SPL trials or permanent placements.
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Observational Study
Evaluating Spinal Cord Stimulation as a Therapeutic Strategy for Postmastectomy Pain Syndrome: A Retrospective Observational Study.
Postmastectomy pain syndrome (PMPS) is a chronic condition that significantly impacts breast cancer survivors, marked by persistent neuropathic pain that is often unresponsive to conventional therapies. Spinal cord stimulation (SCS) has emerged as a promising intervention for managing this type of pain. This study aimed to assess the clinical efficacy of SCS in managing PMPS and identify patient-specific factors impacting treatment outcomes. ⋯ SCS is an effective treatment for PMPS, with age, BMI, psychologic treatments, and prior radiotherapy being significant predictors of outcomes. Tailoring treatment plans to these factors can potentially enhance pain management for patients with PMPS.
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Randomized Controlled Trial
Effects of Pulsed Radiofrequency Duration in Patients With Chronic Lumbosacral Radicular Pain: A Randomized Double-Blind Study.
We hypothesized that the duration of pulsed radiofrequency (PRF) application may affect the effectiveness of PRF in patients with chronic lumbosacral radicular pain (LRP). ⋯ The Clinicaltrials.gov registration number under the Clinical Trial Registry of Korea for the study is KCT0003850; https://cris.nih.go.kr.