Spinal Cord Stimulation Electrode Design: Prospective, Randomized, Controlled Trial Comparing Percutaneous and Laminectomy Electrodes???Part I: Technical Outcomes

North, Richard B.; Kidd, David H.; Olin, John; Sieracki, Jeffrey M.

doi:10.1097/00006123-200208000-00015

Cited by 84 publications

(128 citation statements)

References 23 publications

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“…When applied to the cervical spinal cord, it causes bronchodilation, while SCS delivered to the low thoracic and sacral levels causes vasodilatation and increased bladder volume tolerance [33,45,46,62]. Stimulation of the dorsal portion of the spinal cord can also provoke antidromic inhibition of efferent sympathetic activity, leading to a reduction in peripheral vasoconstriction; additionally, it may induce a peripheral release of vasoactive substances such as calcitonin gene-related peptide and nitric oxide, with consequent peripheral vasodilatation [4,12,33,40,41,45,46,51]. Effective therapeutic SCS for neuropathic pain requires the activation of ascending sensory fibers and causes paresthesias covering the painful area, even though the topographical extension of the paresthesias does not always correspond to the expected dermatomes [57].…”

Section: Discussionmentioning

confidence: 99%

Spinal cord stimulation for Parkinson’s disease: a systematic review

et al. 2015

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Axial symptoms are a late-developing phenomenon in the course of Parkinson's disease (PD) and represent a therapeutic challenge given their poor response to levodopa therapy and deep brain stimulation. Spinal cord stimulation (SCS) may be a new therapeutic approach for the alleviation of levodopa-resistant motor symptoms of PD. Our purpose was to systematically review the effectiveness of SCS for the treatment of motor symptoms of PD and to evaluate the technical and pathophysiological mechanisms that may influence the outcome efficacy of SCS. A comprehensive literature search was conducted using electronic databases for the period from January 1966 through April 2014. The methodology utilized in this work follows a review process derived from evidence-based systematic review and meta-analysis of randomized trials described in the PRISMA statement. Reports examining SCS for the treatment of PD are limited. Eight studies with a total of 24 patients were included in this review. The overall motor score of the Unified Parkinson's Disease Rating Scale in the on/off-stimulation condition remained unchanged in 6 patients and improved in 18 patients after SCS. SCS appears to yield positive results for PD symptoms, especially for impairments in gait function and postural stability. However, evidence is limited and long-term prospective studies will be required to identify the optimal candidates for SCS and the best parameters of stimulation and to fully characterize the effects of stimulation on motor and nonmotor symptoms of PD.

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Section: Discussionmentioning

confidence: 99%

Spinal cord stimulation for Parkinson’s disease: a systematic review

et al. 2015

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“…[23][24][25] With more sophisticated technology and better appreciation of appropriate patient selection criteria, there has been a sustained resurgence of interest in SCS, including its application to treatment of CRPS. 22,[26][27][28][29][30] Reports of success with relatively small samples of patients with CRPS sometimes sprinkled among patients with other chronic pain conditions have suggested potential benefit. 31,32 Unfortunately, the methodologic quality of published reports remains generally weak.…”

Section: Spinal Cord and Peripheral Nerve Stimulationmentioning

confidence: 99%

“…Areas of debate include what constitutes an adequate trial, when should laminotomy (surgically placed) leads be used instead of percutaneous leads, ideal spacing of the electrodes, number of leads, and other matters. 26,30 The decision and timing regarding SCS in the individual case is an unresolved dilemma. Current expert panel treatment consensus guidelines, which emphasize the incorporation of interventional and other treatment modalities as needed to facilitate functional restoration, suggest that it may not be optimal to wait as long as initially believed before consideration of SCS.…”

Section: Spinal Cord and Peripheral Nerve Stimulationmentioning

confidence: 99%

Interventional Therapies in the Management of Complex Regional Pain Syndrome

Nelson

Stacey²

2006

The Clinical Journal of Pain

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Invasive procedures have long held a place in the therapeutic armamentarium for the management of complex regional pain syndrome (CRPS). However, this has evolved considerably, particularly as research into the mechanisms of CRPS has called into question long-held presumptions about the key role of sympathetic dysfunction in the syndrome. This review summarizes some of the key information currently available about interventional treatments, including nerve blocks, spinal cord and peripheral nerve stimulation, chemical and surgical sympathectomies, and deep brain stimulation. The potential roles for these procedures in facilitating functional rehabilitation goals that are primary to the treatment of CRPS are emphasized.

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“…Lead migration and positional effects are commonly observed with percutaneous leads. These effects can be minimized with paddle leads, which have shown to provide more consistent coverage of the painful areas with paresthesia and to optimize stimulation efficiency [7,12]. The placement of paddle leads can be performed under local anesthesia, epidural and spinal anesthesia, and general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Multimodal, Intraoperative Monitoring during Paddle Lead Placement for Cervicothoracic Spinal Cord Stimulation

Choi

Son

2015

Stereotact Funct Neurosurg

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Background and Objective: We investigated the efficacy of combined somatosensory evoked potentials (SSEP) and electromyography monitoring during paddle lead placement through cervicothoracic laminectomy under general anesthesia in a retrospective review of data from 25 patients. Methods: Muscle motor evoked potentials (MEP) recordings and SSEP monitoring were used for surveillance of the spinal cord. Collision testing of SSEP and threshold amplitudes of compound muscle action potentials (CMAP) in the bilateral upper and lower extremities evoked by electrode contacts of the paddle lead were checked to determine the laterality of the lead in the mediolateral direction. Results: A significant decrease in amplitudes of muscle MEP in spite of stable SSEP occurred in 2 patients: 1 patient with a retrograde C₁-C₂ insertion and another patient with an anterograde C₄/C₅ insertion. Repositioning of leads based on significantly asymmetrical collision testing of SSEP and thresholds of CMAP in bilateral extremities was needed in 6 and 8 patients, respectively. In 22 patients, paresthesia coverage of the painful area was consistently located in the painful side, either unilaterally or bilaterally. There was no episode of revision for suboptimal lead placement. Conclusions: Intraoperative neurophysiological guidance using SSEP and muscle MEP was useful for the safe and accurate placement of paddle leads for cervicothoracic SCS.

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Spinal Cord Stimulation Electrode Design: Prospective, Randomized, Controlled Trial Comparing Percutaneous and Laminectomy Electrodes???Part I: Technical Outcomes

Cited by 84 publications

References 23 publications

Spinal cord stimulation for Parkinson’s disease: a systematic review

Spinal cord stimulation for Parkinson’s disease: a systematic review

Interventional Therapies in the Management of Complex Regional Pain Syndrome

Multimodal, Intraoperative Monitoring during Paddle Lead Placement for Cervicothoracic Spinal Cord Stimulation

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