Spinal Cord Stimulation—Hybrid Lead Array: Epidural and Peripheral Nerve Field Stimulation Trial

2018 ◽  
pp. 179-190
Author(s):  
Lucas W. Campos ◽  
Michael Yang
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Spinal Cord Stimulation ◽  
Field Stimulation ◽  
Stimulation Trial ◽  
Lead Array ◽  
Peripheral Nerve Field Stimulation

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.

scholarly journals Present and Potential Use of Spinal Cord Stimulation to Control Chronic Pain

2014 ◽  
Vol 3;17 (3;5) ◽  
pp. 234-246
Author(s):  
Jason J. Song
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Dorsal Root ◽  
High Frequency Stimulation ◽  
Field Stimulation ◽  
Low Back ◽  
Frequency Stimulation ◽  
Peripheral Nerve Field Stimulation

Background: Spinal cord stimulation is an intervention that has become increasingly popular due to the growing body of literature showing its effectiveness in treating pain and the reversible nature of the treatment with implant removal. It is currently approved by the FDA for chronic pain of the trunk and limbs, intractable low back pain, leg pain, and pain from failed back surgery syndrome. In Europe, it has additional approval for refractory angina pectoris and peripheral limb ischemia. Objective: This narrative review presents the current evidence supporting the use of spinal cord stimulation for the approved indications and also discusses some emerging neuromodulation technologies that may potentially address pain conditions that traditional spinal cord stimulation has difficulty addressing. Study Design: Narrative review. Results: Spinal cord stimulation has been reported to be superior to conservative medical management and reoperation when dealing with pain from failed back surgery syndrome. It has also demonstrated clinical benefit in complex regional pain syndrome, critical limb ischemia, and refractory angina pectoris. Furthermore, several cost analysis studies have demonstrated that spinal cord stimulation is cost effective for these approved conditions. Despite the lack of a comprehensive mechanism, the technology and the complexity in which spinal cord stimulation is being utilized is growing. Newer devices are targeting axial low back pain and foot pain, areas that have been reported to be more difficult to treat with traditional spinal cord stimulation. Percutaneous hybrid paddle leads, peripheral nerve field stimulation, nerve root stimulation, dorsal root ganglion, and high frequency stimulation are actively being refined to address axial low back pain and foot pain. High frequency stimulation is unique in that it provides paresthesia free analgesia by stimulating beyond the physiologic frequency range. The preliminary results have been mixed and a large randomized control trial is underway to evaluate the future of this technology. Other emerging technologies, including dorsal root ganglion stimulation and hybrid leads, also show some promising preliminary results in non-randomized observational trials. Limitation: This review is a primer and not an exhaustive review for the current evidence supporting the use of spinal cord stimulation and precursory discussion of emerging neuromodulation technologies. This review does not address peripheral nerve stimulation and focuses mainly on spinal cord stimulation and touches on peripheral nerve field stimulation. Conclusions: Spinal cord stimulation has demonstrated clinical efficacy in randomized control trials for the approved indications. In addition, several open label observational studies on peripheral nerve field stimulation, hybrid leads, dorsal root ganglion stimulation, and high frequency stimulation show some promising results. However, large randomized control trials demonstrating clear clinical benefit are needed to gain evidence based support for their use. Key words: Spinal cord stimulation, chronic pain; low back pain, high frequency stimulation, peripheral nerve field stimulation, dorsal root ganglion stimulation, failed back surgery syndrome, complex regional pain syndrome, critical limb ischemia, refractory angina pectoris

Combined Spinal Cord and Peripheral Nerve Field Stimulation for Persistent Post-Herniorrhaphy Pain

2012 ◽  
Vol 16 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Guilherme Lepski ◽  
Payman Vahedi ◽  
Marcos Soares Tatagiba ◽  
Matthias Morgalla
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Field Stimulation ◽  
Peripheral Nerve Field Stimulation

scholarly journals Peripheral nerve field stimulation for otalgia: A novel therapy for refractory deep ear pain

2014 ◽  
Vol 1 (4) ◽  
pp. 101-104 ◽  
Author(s):  
Mayur Sharma ◽  
Ammar Shaikhouni ◽  
Emam Saleh ◽  
Andrew Shaw ◽  
Milind Deogaonkar
Keyword(s):  
Peripheral Nerve ◽  
Field Stimulation ◽  
Novel Therapy ◽  
Peripheral Nerve Field Stimulation
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