Antibiotics for Spinal Cord Stimulation Trials and Implants: A Survey Analysis of Practice Patterns

Sarrafpour, Syena; Hasoon, Jamal; Urits, Ivan; Viswanath, Omar; Imani, Farnad; Mahmoudi, Kamran; Simopoulos, Thomas; Gill, Jatinder; Kohan, Lynn

doi:10.5812/aapm.120611

Cited by 8 publications

(6 citation statements)

References 38 publications

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“…Procedural complications include infection, epidural abscess, epidural hematoma, post-dural puncture headache, and potentially paralysis. Recent studies have shown infection to be the most frequent procedural complication and lead migration to be the most frequent technical complication (3,18). While various complications can arise, proper candidate selection and medical optimization are suggested to allow for greater improvements in pain in a safe, effective manner.…”

Section: History Of Spinal Cord Stimulationmentioning

confidence: 99%

Burst Spinal Cord Stimulation in the Management of Chronic Pain: Current Perspectives

Edinoff

Kaufman

Alpaugh³

et al. 2022

Anesth Pain Med

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: Over the last several decades, opioid diversion, misuse, and over-prescription have run rampant in the United States. Spinal cord stimulation (SCS) has been FDA approved for treatment for a primary indication of neuropathic limb pain that is resistant to more conservative medical therapy. The disorders qualified for treatment include neuropathic, post-surgical, post-amputation, osteodegenerative, and pain related to vascular disease. Some of the most frequently cited conditions for treatment of SCS include failed back surgery syndrome, complex regional pain syndrome (CRPS) Type I and Type II, and post-herpetic neuralgias. Developments in SCS systems have led to the differentiation between the delivered electromechanical waveform patterns, including tonic, burst, and high-frequency. Burst SCS mitigates traditional paresthesia due to expedited action potential and offers improved pain relief. Burst SCS has been shown in available studies to be non-inferior to the traditional SCS, which can cause pain paresthesia in patients who already have chronic pain. Burst SCS does not seem to cause or need the paresthesia seen in traditional SCS, making SCS not tolerable to patients. Moreover, some studies suggest that burst SCS may decrease opioid consumption in patients with chronic pain. This can make burst SCS an extremely useful tool in the battle against chronic pain and the raging opioid epidemic. As of now, more research needs to be performed to further delineate the effectiveness and long-term safety of this device.

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Section: History Of Spinal Cord Stimulationmentioning

confidence: 99%

Burst Spinal Cord Stimulation in the Management of Chronic Pain: Current Perspectives

Edinoff

Kaufman

Alpaugh³

et al. 2022

Anesth Pain Med

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“…Interventional procedures vary by complexity and invasiveness, including trigger point injections, epidural steroid injections, sympathetic nerve blocks, radiofrequency ablation, cryoneuroablation, intrathecal drug delivery systems, and spinal cord stimulators, and deep brain stimulation ( 40 - 46 ). Although interventional therapies have associated risks, such as infection, dural puncture, spinal cord trauma, or nerve injury, the significant improvement in quality of life for certain patients makes them attractive treatment options, particularly in those who do not respond well to topical or oral analgesic agents ( 47 - 53 ).…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Conolidine: A Novel Plant Extract for Chronic Pain

et al. 2021

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: Pain, the most common symptom reported among patients in the primary care setting, is complex to manage. Opioids are among the most potent analgesics agents for managing pain. Since the mid-1990s, the number of opioid prescriptions for the management of chronic non-cancer pain (CNCP) has increased by more than 400%, and this increased availability has significantly contributed to opioid diversion, overdose, tolerance, dependence, and addiction. Despite the questionable effectiveness of opioids in managing CNCP and their high rates of side effects, the absence of available alternative medications and their clinical limitations and slower onset of action has led to an overreliance on opioids. Conolidine is an indole alkaloid derived from the bark of the tropical flowering shrub Tabernaemontana divaricate used in traditional Chinese, Ayurvedic, and Thai medicine. Conolidine could represent the beginning of a new era of chronic pain management. It is now being investigated for its effects on the atypical chemokine receptor (ACK3). In a rat model, it was found that a competitor molecule binding to ACKR3 resulted in inhibition of ACKR3’s inhibitory activity, causing an overall increase in opiate receptor activity. Although the identification of conolidine as a potential novel analgesic agent provides an additional avenue to address the opioid crisis and manage CNCP, further studies are necessary to understand its mechanism of action and utility and efficacy in managing CNCP.

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“…Whereas the primary indications for spinal cord stimulation remain failed back surgery syndrome and complex regional pain syndrome, there is a growing list of other indications for use, including chronic intractable back pain without previous surgery where other treatments have failed (3)(4)(5). With increasing indications, it is likely that this treatment option will be increasingly utilized in the future (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Contralateral and Lateral Views: Analysis of the Technical Aspects of Spinal Cord Stimulator Lead Insertion

et al. 2022

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Background: Spinal cord stimulation (SCS) is an established treatment modality for neuropathic pain. The critical part of this technique is safe access to the epidural space for lead placement. There have been innovations in radiological views, improving access to the epidural space. Objectives: This study analyzes the adoption of these technical advantages in daily practice Methods: We conducted a survey of members in the Spine Intervention Society and American Society of Regional Anesthesia in regard to the practice patterns in SCS therapy. Here we present our findings regarding the use of contralateral oblique (CLO) and lateral views as well direct upper thoracic or cervicothoracic access for SCS lead insertion Results: A total of 195 unique responses were received between March 20, 2020 and June 26, 2020. Forty-five percent of respondents “always used” the lateral view technique while 15% “always used” CLO view for SCS lead insertion. Overall, sixty-five percent of respondents used the CLO view with varying frequency. Cervical and upper thoracic approach for cervical SCS lead placement is always or often used by 66.8% of the respondents. Conclusions: A depth view (CLO or lateral) is always used by only 45 - 60% of the respondents and CLO view has been rapidly adopted in clinical practice for SCS lead insertion. Direct cervicothoracic and upper thoracic is the preferred approach for cervical lead placement by the majority.

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Antibiotics for Spinal Cord Stimulation Trials and Implants: A Survey Analysis of Practice Patterns

Cited by 8 publications

References 38 publications

Burst Spinal Cord Stimulation in the Management of Chronic Pain: Current Perspectives

Burst Spinal Cord Stimulation in the Management of Chronic Pain: Current Perspectives

Conolidine: A Novel Plant Extract for Chronic Pain

Contralateral and Lateral Views: Analysis of the Technical Aspects of Spinal Cord Stimulator Lead Insertion

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