Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2020
Evaluation of nerve capture using classical landmarks for genicular nerve radiofrequency ablation: 3D cadaveric study.
Radiofrequency (RF) denervation of the superolateral genicular nerve (SLGN), superomedial genicular nerve (SMGN) and inferomedial genicular nerve (IMGN) is commonly used to manage chronic knee joint pain. However, knowledge of articular branches captured, using classical landmarking techniques, remains unclear. In order to enhance and propose new RF procedures that conceivably capture a greater number of articular branches, more detailed cadaveric investigation is required. The objectives were to (1) determine which articular branches are captured or spared using classical landmarking techniques, and (2) evaluate the anatomical feasibility of classical landmarking techniques using three-dimensional (3D) modeling technology. ⋯ This study provides anatomical evidence supporting the effectiveness of classical landmarking for genicular nerve ablation; however, each technique resulted in sparing of articular branches. The extensive innervation of the knee joint suggests the use of supplementary landmarks to improve capture rates and potentially patient outcomes.
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Reg Anesth Pain Med · Nov 2020
Pocket pain, does location matter: a single-centre retrospective study of patients implanted with a spinal cord stimulator.
Spinal cord stimulation (SCS) is an effective therapy for alleviating pain but reported complication rates vary between healthcare centers. This study explored the prevalence of pain associated with Implantable Pulse Generators (IPGs), the component that powers the SCS system. ⋯ These findings suggest that IPG site pain is a common complication, contributing to SCS revisions and explantation. This study shows that anatomical factors and baseline characteristics of individual patients may contribute to IPG site pain and indicates that exploration of potential factors leading to IPG revision is required.
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Reg Anesth Pain Med · Nov 2020
Explant rates of electrical neuromodulation devices in 1177 patients in a single center over an 11-year period.
The publication of explant rates has established risk factors and a definitive objective outcome of failure for spinal cord stimulation (SCS) treating neuropathic pain. We present a UK study analyzing explants of electrical neuromodulation devices for different conditions over 11 years in a single center specializing in neuromodulation. ⋯ These data contribute to a growing list of explant data in the scientific literature and give indications of what factors contribute to long-term utilization of electrical neuromodulation devices.