Neuromodulation : journal of the International Neuromodulation Society
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Idiopathic overactive bladder, urgency-frequency syndromes, interstitial cystitis, pudendal neuralgia, vulvodynia, prostadynia, and coccygodynia have been effectively treated with sacral nerve root modulation. This is most commonly performed with placement of electrodes via a transforaminal approach, predominately to the S3 foramen. This approach is limited by a high lead migration rate and the limitations of stimulating a single nerve root. Beginning in the 1990s, some centers began pursuing retrograde percutaneous placement from the lumbar spine, but adoption of this technique was limited by the technical difficulty of the approach. ⋯ The "laterograde" modification of cephalocaudal approach appears to be technically less difficult method for accomplishing sacral nerve root stimulator electrode placement over multiple roots.
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Sacroiliac joint (SIJ) dysfunction is a significant contributing factor in 10-30% of individuals with lower back pain. However, definitive diagnostic methods and treatments are still controversial. ⋯ Sacral nerve stimulation with a percutaneous retrograde cephalocaudal approach is considered to be a useful therapeutic option in the treatment of intractable SIJ dysfunction.
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We compared the role of subthalamic nucleus deep brain stimulation (STN-DBS) in the management of medically refractory idiopathic Parkinson's disease in patients with relatively young onset (<40 years of age) Parkinson's disease (YOPD) and patients with relatively late onset Parkinson's disease (≥ 56 years of age, rLOPD). ⋯ Patients with YOPD and rLOPD exhibited comparable UPDRS motor scores and LEDD six months postoperatively. Levodopa could be prescribed at optimum doses following STN-DBS in patients with YOPD as abnormal movements are better controlled following STN-DBS implantation. Stimulation parameters were not different between the two groups. Our results suggest the age of onset does not influence response to STN-DBS Parkinson's disease patients.
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Our goal was to determine the efficacy of spinal cord stimulation for patients with intractable post-herniorrhaphy pain which conventional treatment failed to ameliorate. ⋯ We conclude that SCS offers an alternative treatment option for intractable post-herniorrhaphy pain. This type of treatment should be considered for use in a select group of patients when all conventional treatments failed.
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We evaluated trends in inpatient spinal cord stimulation (SCS) for the 14-year period from 1993 to 2006. ⋯ Given the expense of these systems, it is important to assess not only the efficacy of novel neuromodulatory interventions, but also their cost. Future studies should be designed with these important outcome measures in mind.