Spinal Cord Stimulation for Pain Treatment After Spinal Cord Injury

Huang, Qian; Duan, Wanru; Sivanesan, Eellan; Yang, Fei; Chen, Zhiyong; Ford, Neil C.; Chen, Xueming; Guan, Yun

doi:10.1007/s12264-018-0320-9

Cited by 40 publications

(47 citation statements)

References 164 publications

(225 reference statements)

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“…Of the 2 newer reports included in the Huang et al review, the case report by Reck and Landmann was included in our review as well, while our search strategy did not identify the Levine et al case series …”

Section: Resultsmentioning

confidence: 99%

“…Our review as well as the reviews by Huang et al and Lagauche et al highlight the need for a dedicated prospective clinical trial investigating the safety and feasibility of SCS for the treatment of pain in the SCI population. Refractory neuropathic pain in individuals with SCI is difficult to treat, and the burden of pain in such patients can be incredibly severe, including significant psychological sequelae.…”

Section: Future Directionsmentioning

confidence: 87%

“…No difference in SCI or spinal hematoma risk between percutaneous or a paddle lead was found. Given the higher incidence of anatomical variations and hardware placement, the relative risk of these procedures may be higher in the SCI population …”

Section: Discussionmentioning

confidence: 99%

“…Given the higher incidence of anatomical variations and hardware placement, the relative risk of these procedures may be higher in the SCI population. 19 Many of the initial publications on SCS in SCI concluded that those with incomplete injuries had better pain responses than those with complete injuries. 15,16 Three included reports described experiences with complete SCI.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Huang et al provided a thoughtful summary of the development of nociceptive and neuropathic pain following SCI, theories behind how different SCS paradigms treat pain, and a focused update on SCS in the SCI population. When compared to the Lagauche et al review, Huang et al discussed 2 additional studies. One was a case report where burst SCS with leads placed at T11–L1 in a 53 year old woman with a T5 complete SCI improved the numeric rating scale (NRS) score from 7/10 to 4/10 at 3‐month follow‐up .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Current Evidence Lacking to Guide Clinical Practice for Spinal Cord Stimulation in the Treatment of Neuropathic Pain in Spinal Cord Injury: A Review of the Literature and a Proposal for Future Study

et al. 2020

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Background/Objective Chronic pain is commonly reported in individuals with spinal cord injuries (SCIs), with recent prevalence reported as high as 80%. Uncontrolled pain is known to decrease quality of life, attenuate mood, and impact sleep. Spinal cord stimulation (SCS) for the treatment of refractory pain was first used in the SCI population in 1972. To date there have been no randomized controlled trials examining the effect of SCS on neuropathic pain post‐SCI. A literature review in 2009 identified 27 studies, the majority prior to 2000, that included at least 1 patient with SCI. Given the significant advancements in the field of SCS, this review examines the updated evidence of SCS for the treatment of neuropathic pain in individuals with SCI and provides guidance on future investigations. Methods MEDLINE and EMBASE databases were searched. All published reports, case series, and clinical trials reviewing SCS for neuropathic pain that included at least 1 individual with SCI were included. Results The initial search identified 376 reports, of which 22 met inclusion criteria, for a total of 69 patients. All reports were of very low quality. A majority of the reported patients were male, underwent tonic stimulation, and reportedly experienced improvement in pain and spasticity, with decreased use of pain medication. Conclusions The synthesized findings from primarily case studies support the safety of SCS in SCI with the suggestion of potential pain relief benefit; however, data from low‐quality studies are insufficient for informing clinical practice. A well‐designed, prospective clinical trial is proposed to further investigate this indication.

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Section: Resultsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current Evidence Lacking to Guide Clinical Practice for Spinal Cord Stimulation in the Treatment of Neuropathic Pain in Spinal Cord Injury: A Review of the Literature and a Proposal for Future Study

et al. 2020

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Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions

Tringides

Mooney

2022

Advanced Materials

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with the outermost layer of biological tissues, often spanning a significant surface area. Devices typically have multiple electrodes that aim to monitor and modulate cells and tissues in a minimally invasive manner, using biomaterials designed to evoke minimal inflammatory responses. Applications of Surface Electrode Arrays RecordingBecause surface electrode arrays can record a "snapshot" of the electrical activity at distinct locations, these arrays are useful to monitor the function of a tissue. Though the recordings are typically local field potentials, with electrodes that are small enough to modulate as little of a location as possible while still maintaining a sufficiently high conductivity, single units from individual cells have been reported. Clinically, these recordings are used to map the epicardial surface to identify instances, and potentially mechanisms, of chronic atrial fibrillation, [1] dysfunction of ventricular tachycardia caused by congenital defects, [2] and other abnormal conduction conditions in the cardiac system. Clinical electrocorticogram (ECoG) is used to identify similar functional changes on the cortical surface of the brain, most commonly to identify epileptic focal center(s), or detect seizure activity. [3][4][5][6][7] Other functional uses of ECoG include intraoperative monitoring during tumor resection. [8] A surgeon can ask a patient to perform an activity such as a speech and then identify and avoid the active cortical regions during surgery, to avoid major disruptions to the patient quality of life. StimulationInstead of passively monitoring electrical activity, multielectrode surface arrays can provide electrical current to the underlying tissue and induce a desired excitatory or inhibitory response. The applications for stimulating surface electrode arrays are often therapeutic and include implantable pacemakers, which restore a normal cardiac rhythm by providing external and overriding cues to the cardiomyocytes responsible for establishing a sinus rhythm. [9] Pulses delivered to specific regions of the spinal cord are used to manage chronic pain, [10][11][12] and more recently as a therapy to promote neuronal plasticity in Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first r...

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Central Nervous System Pain

Salahuddin

Gebreyohanns

2020

Pain Management for Clinicians

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Spinal Cord Stimulation for Pain Treatment After Spinal Cord Injury

Cited by 40 publications

References 164 publications

Current Evidence Lacking to Guide Clinical Practice for Spinal Cord Stimulation in the Treatment of Neuropathic Pain in Spinal Cord Injury: A Review of the Literature and a Proposal for Future Study

Current Evidence Lacking to Guide Clinical Practice for Spinal Cord Stimulation in the Treatment of Neuropathic Pain in Spinal Cord Injury: A Review of the Literature and a Proposal for Future Study

Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions

Central Nervous System Pain

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