scholarly journals Percutaneous Peripheral Nerve Stimulation for Pain Reduction and Improvements in Functional Outcomes in Chronic Low Back Pain

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 537-541 ◽  
Author(s):  
Steven Cohen ◽  
Christopher Gilmore ◽  
Leonardo Kapural ◽  
Steven Hanling ◽  
Anthony Plunkett ◽  
...  

Abstract Chronic low back pain represents one of the most common sources of disability and a significant healthcare burden for the U.S. military. Present treatments for chronic back pain are often ineffective, poorly tolerated, invasive, destructive, and/or associated with complications and lead to the progression to invasive surgical procedures. There have been multiple calls for the development of a minimally invasive system that is effective without the risks or complications of existing surgical therapies, which could prevent the need for surgery and the recurrence of pain. The goal of this study was to evaluate a novel, minimally invasive approach using a percutaneous peripheral nerve stimulation (PNS) system designed to provide pain relief without surgery, to reduce complications, and provide a less-invasive treatment option. In nine subjects, percutaneous PNS improved participants’ function, as evidenced by clinically and statistically significant reductions in pain, disability, and pain interference. Subjects also experienced reductions in opioid and non-opioid analgesic medication usage and reported improvements in quality of life with treatment. There were no serious or unanticipated adverse events. These results demonstrate the potential of percutaneous PNS as a non-surgical therapy to treat chronic back pain without opioids.

2019 ◽  
Vol 184 (11-12) ◽  
pp. e954-e954 ◽  
Author(s):  
Steven P Cohen ◽  
Christopher A Gilmore ◽  
Leonardo Kapural ◽  
Steven R Hanling ◽  
Anthony R Plunkett ◽  
...  

Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S41-S46
Author(s):  
Christopher A Gilmore ◽  
Janus Patel ◽  
Lasha-Giorgi Esebua ◽  
Michael Burchell

Abstract Objectives The lumbar medial branch nerve has historically been a focus for ablative techniques in the treatment of chronic low back pain (CLBP) of facetogenic origin. Recent developments in the field of neuromodulation have been employed to target these nerves for analgesia and/or functional restoration in broader populations of CLBP patients. The objective of this article was to provide an introductory review of procedural techniques and devices employed for peripheral nerve stimulation (PNS) of the lumbar medial branch of the dorsal ramus for the treatment of CLBP. Methods A literature search via PubMed.gov was performed through September 2019 with key words focusing on peripheral nerve stimulation for chronic low back pain. This was refined to include only those articles that focused specifically on stimulation of the lumbar medial branch of the dorsal ramus. References within selected articles and unpublished data currently in the peer review process were also utilized. Results Ninety articles from PubMed.gov were obtained. Two approaches to PNS of the medial branch of the dorsal ramus were identified. Conclusions Our review of the current literature regarding techniques for neuromodulation of the medial branch of the dorsal ramus revealed two dominant methods: a temporarily implanted percutaneous coiled-lead approach and a permanently implanted system. The two techniques share some similarities, such as targeting the medial branch of the dorsal ramus, and also have some differences, such as indwelling time, stimulation parameters, duration of treatment, image guidance, and degrees of invasiveness, but they are both demonstrating promising results in clinical trials.


Pain Practice ◽  
2017 ◽  
Vol 18 (1) ◽  
pp. 94-103 ◽  
Author(s):  
Leonardo Kapural ◽  
Christopher A. Gilmore ◽  
John Chae ◽  
Richard L. Rauck ◽  
Steven P. Cohen ◽  
...  

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