Neuromodulation : journal of the International Neuromodulation Society
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The implantation of a drug (opioid) infusion system catheter at the level of the cisterna magna, connected to an implanted programmable pump (Synchromed pump, 8611-H, Medtronic, Minneapolis, MN) is the procedure we use most commonly for the treatment of craniofacial and upper cervical pain. Our implantation technique, which we consider simple and easy to perform, is discussed in this article. Our results have been extremely encouraging, without untoward effects occurring. Adverse effects are prevented by the close proximity of the catheter tip to the pain receptors.
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We report a case of spinal cord stimulation (neurostimulation) as treatment of angina pectoris pain in a patient with an implantable cardioverter-defibrillator. The precautions taken to avoid inhibition of the demand pace function and avoid activation of the shock function by the neurostimulation are discussed.
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Intrathecal drug therapy has become an indispensable tool in the treatment of many different neurologic disorders. It allows targeted infusion of small quantities of drugs, thereby increasing effectiveness while reducing unwanted side effects typically seen in oral drug administration. The following paper discusses the current technology in constant rate intrathecal drug-infusion delivery systems and the effect of pressure and temperature on flow rate accuracy.