Neuromodulation : journal of the International Neuromodulation Society
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Ziconotide is a peptide that blocks N-type calcium channels and is antihyperalgesic after intrathecal (IT) delivery. We here characterize the spinal kinetics of IT bolus and infused ziconotide in dog. ⋯ After IT bolus or infusion, ziconotide displays linear kinetics that are consistent with a hydrophilic molecule of approximately 2500 Da that is cleared slightly more rapidly than inulin from the LCSF. Behavioral effects were dose dependent and reversible.
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To demonstrate that spinal cord stimulators (SCSs) may be placed safely and accurately under general anesthesia (GA) and that the proposed evaluation method activates structures predominantly in the dorsal columns. ⋯ GA SCS is safe and appears to be at least as accurate and efficacious as using the awake SCS placement technique based on a 50% improvement in the VAS. In addition, the technique presented herein demonstrates that the test stimuli activate the same fiber tracts as that of the therapeutic stimulation.
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Review Case Reports
Spinal cord stimulation in pregnancy: a literature review.
Currently, the use of spinal cord stimulation (SCS) therapy is not recommended in pregnancy because the effects of SCS on the pregnancy and developing fetus are unknown. However, many SCS recipients are women of childbearing age who may later become pregnant. The purpose of the present report is to review and summarize the existing literature on the use of SCS therapy during the prenatal period. ⋯ Women of childbearing age who are candidates for SCS implantation should be tested for pregnancy prior to implantation surgery. They also should be informed about the limited state of our scientific knowledge regarding the impact of this technology on reproductive health. For patients already implanted with SCS, decisions about ongoing use in the event of pregnancy should be made on an individual basis after a careful consideration of potential risks and benefits.
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Randomized Controlled Trial Multicenter Study
Spinal cord stimulation therapy for patients with refractory angina who are not candidates for revascularization.
The aim of this study was to evaluate the safety and efficacy of spinal cord stimulation (SCS) for refractory angina. ⋯ Although this study was terminated early, the results obtained at six months suggest that SCS (HS) is not more effective than the control (LS) in patients with refractory angina.
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To review the evidence in observational studies of the effect of spinal cord stimulation (SCS) in patients with refractory angina pectoris (RAP) due to obstructive coronary artery disease. The effect of SCS in patients with refractory microvascular angina (MVA) also was assessed. ⋯ In observational studies, SCS showed to be an effective form of treatment for RAP, including refractory MVA. The treatment appears to be safe both at short- and long-term follow-up.