Pain physician
-
Randomized Controlled Trial Multicenter Study
Automatic adaptation of neurostimulation therapy in response to changes in patient position: results of the Posture Responsive Spinal Cord Stimulation (PRS) Research Study.
Variation in the intensity of neurostimulation with body position is a practical problem for many patients implanted with a spinal cord stimulation system because positional changes may result in overstimulation or understimulation. These posture-related changes in patients' perception of paresthesia can affect therapeutic outcomes of spinal cord stimulation therapy. An accelerometer-based algorithm that automatically adjusts spinal cord stimulation based on sensed body position or activity represents a potential solution to the problem of position-mediated variations in paresthesia perception. ⋯ Patients preferred automatic versus manual adjustment of stimulation amplitude in response to changes in paresthesia consequent to positional changes during in-clinic testing.
-
Randomized Controlled Trial
Effect of addition of epidural ketamine to steroid in lumbar radiculitis: one-year follow-up.
Treating sciatica with epidural steroid injection has been a common practice worldwide. N-methyl-D-aspartate (NMDA) receptors are an important component of pain pathways. ⋯ Epidurally administrated ketamine seems to be a safe and useful adjunct to epidural corticosteroid therapy in chronic lumbar radicular pain.