On Electrode Configuration for Low-Back Peripheral Nerve Field Stimulation

2014 ◽  
pp. 585-590 ◽  
Author(s):  
Carsten Dahl Mørch ◽  
Louis Vera-Portocarrero ◽  
Ken Steffen Frahm
Keyword(s):  
Peripheral Nerve ◽  
Electrode Configuration ◽  
Field Stimulation ◽  
Low Back ◽  
Peripheral Nerve Field Stimulation

Peripheral Nerve Field Stimulation: A Novel Treatment for Chronic Low Back Pain.

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S4-S5
Author(s):  
Bruce Mitchell ◽  
David Vivian ◽  
Paul Verrills ◽  
Chantelle Sinclair
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Peripheral Nerve ◽  
Chronic Low Back Pain ◽  
Field Stimulation ◽  
Low Back ◽  
Novel Treatment ◽  
Peripheral Nerve Field Stimulation

scholarly journals Cross Talk: A New Method for Peripheral Nerve Stimulation. An Observational Report with Cadaveric Verification

2009 ◽  
Vol 6;12 (6;12) ◽  
pp. 965-983
Author(s):  
Frank Falco
Keyword(s):  
Peripheral Nerve ◽  
Cross Talk ◽  
Nerve Stimulation ◽  
Subcutaneous Fat ◽  
Electrical Circuit ◽  
Peripheral Nerve Stimulation ◽  
Field Stimulation ◽  
Low Back ◽  
Observational Report ◽  
Peripheral Nerve Field Stimulation

Background: Relief of regional, non-appendicular pain, particularly low back pain, through spinal cord stimulation (SCS) has proven challenging. Recently, peripheral nerve stimulation (PNS), also known as peripheral nerve field stimulation (PNFS) depending on the stimulation area, has demonstrated efficacy for the treatment of well-localized, small areas of pain involving the abdomen, inguinal region, pelvis, face, occipital area, and low back. More widespread application of peripheral nerve stimulation has been limited by its narrow field of coverage in a larger group of patients with diffuse or poorly localized pain. Objectives: To determine if cross talk (the creation of an electrical circuit and therefore electrical stimulation between separate subcutaneously placed PNS leads [i.e. inter-lead stimulation]) was clinically possible across large painful areas, assess the breadth of stimulation coverage via cross talk, evaluate the clinical efficacy of peripheral nerve stimulation cross talk (PNSCT), and confirm the existence of cross talk across a large area in a cadaveric model. Study Design: Case series observational report and cadaveric experimentation. Setting: A private, comprehensive interventional pain management practice with pain medicine fellowship training in the United States. Methods: Eighteen consecutive patients with non-appendicular, regional pain were included in the study. Data collection for the implanted patients included the presence or absence of stimulation between the PNS leads, stimulation tolerability, stimulation region, lead orientation, lead montage, inter-lead distance, and pain relief from PNSCT compared to PNS without cross talk. A cadaveric analysis was performed to determine the presence or absence of an electrical circuit with 2 subcutaneously PNS leads to confirm or refute the existence of electrical stimulation from on lead to the other within subcutaneous fat with the leads placed at a significant distance apart from one another. Results: All 18 patients experienced significant pain relief, reduction of pain medication, and functional improvement. Cadaveric experimentation confirmed the presence of an electrical circuit with PNS leads placed at a distance far apart from one another and verified that interlead stimulation (cross talk) does occur in subcutaneous fat over a great distance. Limitations: This study was limited by its small sample size, and the short-term follow-up after implantation. Conclusions: The use of the PNSCT technique allows for significant analgesia for large painful areas that have been poorly captured using traditional SCS techniques and not considered as an option with the current application of peripheral nerve stimulation. Key words: Peripheral nerve stimulation, peripheral nerve field stimulation, cross talk, spinal cord stimulation, neuromodulation, low back pain, failed back surgery syndrome, abdominal pain, neck pain, post herpetic neuralgia, occipital headaches

scholarly journals VP191 Peripheral Nerve Field Stimulation For Chronic Low Back Pain

2017 ◽  
Vol 33 (S1) ◽  
pp. 238-238
Author(s):  
Marc Rhainds ◽  
Brigitte Larocque ◽  
Sylvain Bussières ◽  
Alice Nourrisat ◽  
Martin Coulombe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Peripheral Nerve ◽  
Chronic Low Back Pain ◽  
Spinal Cord Stimulation ◽  
Small Sample ◽  
Field Stimulation ◽  
Low Back ◽  
Peripheral Nerve Field Stimulation

INTRODUCTION:Despite numerous medical, pharmacological and surgical approaches for chronic low back pain (LBP), many patients continue to complain of severe disabling pain. Peripheral nerve field stimulation (PNfS), alone or combined with spinal cord stimulation, is a neuromodulation procedure that have been recently developed and implemented in our hospital. We conducted a Health Technology Assessment (HTA) to determine if PNfS may be considered as a standard of practice in the management of intractable LBP and failed back surgery syndrome (FBSS).METHODS:An interdisciplinary group of experts was involved in the project. A systematic review (SR) was performed in several databases and grey literature to identify clinical practice guidelines, SR and observational studies published through September 2016. A survey was conducted among other chronic pain centers in Canada to document PNfS use in LBP and FBSS treatment.RESULTS:Data on effectiveness and safety of PNfS in chronic LBP treatment were scarce. Short-term results (3-12 months) from small sample and low quality studies suggest that PNfS, alone or combined with spinal cord stimulation, is associated with pain intensity and opioid use reductions. Effects on functional status and quality of life remain undetermined. Most frequent adverse events reported with PNfS devices are lead migrations, discomfort or pain and surgical site infections. No other Canadian pain centers were found to use PNfS in chronic LBP or FBSS.CONCLUSIONS:PNfS is potentially a beneficial treatment option for patients with chronic low back pain or FBSS. However, the value of this innovative treatment remains unknown. Among factors to be clarified are target population (any chronic low back pain or FBSS), use of PNfS alone or combined with spinal cord stimulation, long-term effects, and comparison with conventional medical management. PNfS use in chronic LBP has to be assessed through a rigorous framework before its introduction as a standard medical practice.

Sign in / Sign up

Export Citation Format

Share Document