Pain physician
-
Lead migration (LM) is the most common complication after spinal cord stimulation (SCS). Although multiple reports of caudad LM have been described, cephalad LM has not been reported. Here we describe a case in which a stimulator lead migrates in the cephalad direction. ⋯ We provide the first case report of significant cephalad LM following SCS lead implantation. This migration can occur despite the use of current standard anchoring techniques. Additional investigation into the mechanism of such LM and lead-securing techniques is warranted.
-
Randomized Controlled Trial Multicenter Study
Sensor-driven position-adaptive spinal cord stimulation for chronic pain.
Variation in the intensity of neurostimulation due to body position is a practical problem for many patients implanted with spinal cord stimulation (SCS) systems because positional changes may result in overstimulation or understimulation that leads to frequent need for compensatory manual programming adjustments. ⋯ NCT01106404.
-
Randomized Controlled Trial
Lumbar interlaminar epidural injections in central spinal stenosis: preliminary results of a randomized, double-blind, active control trial.
Chronic, persistent low back and lower extremity pain is often caused by spinal stenosis. Surgery and other interventions, including epidural injections, have been used to relieve this pain. However, there is little in the medical literature to support interlaminar, or transforaminal epidural injections under fluoroscopy for managing lumbar pain of central spinal stenosis, while the caudal epidural approach has been studied. ⋯ NCT00681447.
-
Intrathecal delivery of baclofen (ITB) is effective at controlling spasticity. However, it requires the placement of a catheter into the intrathecal space, and a pump with a reservoir for the medication. The process of placing the catheter and pump are prone to complications. ⋯ Complication rates after placement of intrathecal pump/catheters have increased in the pediatric population between 1997 and 2006 mainly due to an increase in mechanical complications.