Does pain relief with spinal cord stimulation for angina conceal myocardial infarction?

Abstract Forty-three patients with chronic pain disorders of different causes were selected for spinal cord stimulation. All underwent implantation of a ribbon electrode through a small laminotomy, under general anesthesia. Thirteen patients (30%) failed to obtain significant pain relief during a period of trial stimulation, and their electrodes were removed. The remainder underwent a definitive implant and were followed for a mean of 13 months (range, 3-33 months). Nineteen of them (63%) continued to experience pain relief. A detailed analysis of this series, as well as a literature review, is presented.

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Pain Relief and Safety Outcomes with Cervical 10 kHz Spinal Cord Stimulation: Systematic Literature Review and Meta-analysis

Pain and Therapy ◽

10.1007/s40122-021-00269-6 ◽

2021 ◽

Author(s):

Ganesan Baranidharan ◽

Beatrice Bretherton ◽

Craig Montgomery ◽

John Titterington ◽

Tracey Crowther ◽

...

Keyword(s):

Spinal Cord ◽

Pain Relief ◽

Literature Review ◽

Systematic Literature Review ◽

Spinal Cord Stimulation ◽

Meta Analysis ◽

Safety Outcomes

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Increased Pain Catastrophizing Associated With Lower Pain Relief During Spinal Cord Stimulation: Results From a Large Post-Market Study

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.12287 ◽

2015 ◽

Vol 18 (4) ◽

pp. 277-284 ◽

Cited By ~ 15

Author(s):

Jason C. Rosenberg ◽

David M. Schultz ◽

Luis E. Duarte ◽

Steven M. Rosen ◽

Adil Raza

Keyword(s):

Spinal Cord ◽

Pain Relief ◽

Spinal Cord Stimulation ◽

Pain Catastrophizing ◽

Post Market ◽

Lower Pain

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Pain relief and quality-of-life improvement after spinal cord stimulation in painful diabetic polyneuropathy: a pilot study

British Journal of Anaesthesia ◽

10.1093/bja/aes390 ◽

2012 ◽

Vol 109 (5) ◽

pp. 837 ◽

Cited By ~ 1

Author(s):

W.A. Pluijms ◽

R Slangen ◽

M Bakkers ◽

C.G. Faber ◽

I.S.J. Merkies ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Pilot Study ◽

Pain Relief ◽

Spinal Cord Stimulation ◽

Diabetic Polyneuropathy ◽

Life Improvement

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High Frequency Spinal Cord Stimulation in a Patient with Bilateral Cochlear Implants

Pain Management Case Reports ◽

10.36076/pmcr.2021.5.189 ◽

2021 ◽

pp. 189-191

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Pain Relief ◽

Cochlear Implant ◽

Cochlear Implants ◽

Spinal Cord Stimulation ◽

High Frequency ◽

Pain Clinic ◽

Bilateral Cochlear Implants ◽

Patient Reported

BACKGROUND: High-frequency spinal cord stimulation (HF-SCS) has become very popular in the management of chronic pain worldwide. As it relies on generating high-frequency electrical impulses, there is a risk of interference with other devices such as cochlear implants that utilize similar principles. A literature search did not reveal any case reports of HF-SCS implantation in a patient with cochlear implants. CASE REPORT: A 75-year-old White woman with a history of bilateral cochlear implants (Cochlear Americas Nucleus® with cp910 processor) for severe sensorineural hearing loss presented to our chronic pain clinic with lumbosacral radiculopathy. The patient underwent a HF-SCS trial with entry point at the L1-L2 space and the leads positioned at the top and bottom of T8. The patient did not experience any auditory interference with her Cochlear implant at triple the average SCS stimulation strength. During the follow-up visit the next week, the patient reported nearly 80% symptomatic pain relief and significant functional improvement. There was no change in her hearing and no evidence of interference. The patient ultimately underwent percutaneous SCS paddle electrode placement and at 3 months, continues to have excellent pain relief without any auditory interactions. CONCLUSION: We successfully implanted a HF-SCS at the thoracic level in a patient with bilateral cochlear implants without any auditory interference. KEY WORDS: Cochlear implant, lumbar radiculopathy, spinal cord stimulation

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Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial

Diabetes Care ◽

10.2337/dc14-0684 ◽

2014 ◽

Vol 37 (11) ◽

pp. 3016-3024 ◽

Cited By ~ 89

Author(s):

Rachel Slangen ◽

Nicolaas C. Schaper ◽

Catharina G. Faber ◽

Elbert A. Joosten ◽

Carmen D. Dirksen ◽

...

Keyword(s):

Spinal Cord ◽

Randomized Controlled Trial ◽

Peripheral Neuropathy ◽

Pain Relief ◽

Spinal Cord Stimulation ◽

Diabetic Peripheral Neuropathy ◽

Controlled Trial ◽

Randomized Controlled ◽

Painful Diabetic Peripheral Neuropathy

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Spinal Cord Stimulation in Treatment of Chronic Benign Pain: Challenges in Treatment Planning and Present Status, a 22-Year Experience

Neurosurgery ◽

10.1227/01.neu.0000192162.99567.96 ◽

2006 ◽

Vol 58 (3) ◽

pp. 481-496 ◽

Cited By ~ 264

Author(s):

Krishna Kumar ◽

Gary Hunter ◽

Denny Demeria

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Pain Relief ◽

Success Rate ◽

Spinal Cord Stimulation ◽

Pain Clinic ◽

Axial Component

Abstract OBJECTIVE: To present an in-depth analysis of clinical predictors of outcome including age, sex, etiology of pain, type of electrodes used, duration of pain, duration of treatment, development of tolerance, employment status, activities of daily living, psychological status, and quality of life. Suggestions for treatment of low back pain with a predominant axial component are addressed. We analyzed the complications and proposed remedial measures to improve the effectiveness of this modality. METHODS: Study group consists of 410 patients (252 men, 58 women) with a mean age of 54 years and a mean follow-up period of 97.6 months. All patients were gated through a multidisciplinary pain clinic. The study was conducted over 22 years. RESULTS: The early success rate was 80% (328 patients), whereas the long-term success rate of internalized patients was 74.1% (243 patients) after the mean follow-up period of 97.6 months. Hardware-related complications included displaced or fractured electrodes, infection, and hardware malfunction. Etiologies demonstrating efficacy included failed back syndrome, peripheral vascular disease, angina pain, complex regional pain syndrome I and II, peripheral neuropathy, lower limb pain caused by multiple sclerosis. Age, sex, laterality of pain or number of surgeries before implant did not play a role in predicting outcome. The percentage of pain relief was inversely related to the time interval between pain onset and time of implantation. Radicular pain with axial component responded better to dual Pisces electrode or Specify-Lead implantation. CONCLUSION: Spinal cord stimulation can provide significant long-term pain relief with improved quality of life and employment. Results of this study will be effective in better defining prognostic factors and reducing complications leading to higher success rates with spinal cord stimulation.

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Choice of spinal cord stimulation versus targeted drug delivery in the management of chronic pain: a predictive formula for outcomes

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2019-100859 ◽

2020 ◽

pp. rapm-2019-100859

Author(s):

Nagy Mekhail ◽

Diana S Mehanny ◽

Sherif Armanyous ◽

Shrif Costandi ◽

Youssef Saweris ◽

...

Keyword(s):

Drug Delivery ◽

Spinal Cord ◽

Pain Relief ◽

Targeted Drug Delivery ◽

Spinal Cord Stimulation ◽

Pain Treatment ◽

Cleveland Clinic ◽

Cost Effective ◽

Implantable Devices ◽

Targeted Drug

Contemporary nonmalignant pain treatment algorithms commence with conservative non-invasive strategies, later progressing from minimally invasive interventions to invasive techniques or implantable devices. The most commonly used implantable devices are spinal cord stimulation (SCS) systems or targeted drug delivery (TDD) devices. Historically, SCS had been considered in advance of TDD, positioning TDD behind SCS failures. Following Institutional Review Board approval, data were extracted from electronic medical records of patients who underwent SCS trial in the Department of Pain Management at Cleveland Clinic from 1994 to 2013. The sample size was analyzed in two cohorts: those who succeeded with SCS and those who failed SCS and consequently proceeded to TDD. Univariate and multivariate analyses were performed and a predictive formula for successful outcomes was created. 945 patients were included in the cohort of which 119 (12.6%) subjects achieved adequate pain relief with TDD after failure of SCS. Gender, age, depression and primary pain diagnosis were significantly different in this subgroup. Males were 52% less likely to experience pain relief with SCS. The odds of SCS success decreased as age increased by 6% per year. Patients with comorbid depression, interestingly, were 63% more likely to succeed with SCS. A logistic model was created to predict SCS success which was used to create a predictive formula. Older male patients diagnosed with spine-related pain were more likely to benefit from TDD than SCS. This observation potentially identifies a subgroup in whom consideration for TDD in advance of SCS failure could prove more efficient and cost effective. These retrospective findings warrant prospective comparative studies to validate this derived predictive formula.

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Spinal Cord Stimulation for Chronic Pain Relief: First Experience in Baltics

Acta Chirurgica Latviensis ◽

10.2478/v10163-012-0040-6 ◽

2011 ◽

Vol 11 (1) ◽

pp. 180-181

Author(s):

Iveta Golubovska ◽

Aleksejs Miscuks ◽

Vitolds Jurkevics ◽

Sarmite Skaida

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Pain Relief ◽

Low Income ◽

Spinal Cord Stimulation ◽

Pain Syndrome ◽

Neuropathic Pain Syndrome ◽

Patient Status ◽

First Case

Spinal Cord Stimulation for Chronic Pain Relief: First Experience in BalticsWe report the first case of spinal cord stimulator implantation in Baltics to patient with massive posttraumatic plexus lumbosacralis dxtr lesion, severe neuropathic pain syndrome and drug addiction problems. Follow-up time is 6 month since December 2011 and we have observed an obvious clinical and social improvement in patient status. Besides significant pain relief she has got employed and is tax payer instead of low-income person.

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Protocolized High-Dose (HD) and Low-Dose (LD) Spinal Cord Stimulation (SCS) Workflow Results in Meaningful Pain and Opiate Reduction

Neurosurgery ◽

10.1093/neuros/nyz310_190 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Sarah E Hodges ◽

Shervin Rahimpour ◽

Luis Alejandro Antezana ◽

Abena A Ansah-Yeboah ◽

Rajeev Dharmapurikar ◽

...

Keyword(s):

Spinal Cord ◽

Pain Relief ◽

Real World ◽

Spinal Cord Stimulation ◽

Low Dose ◽

High Dose ◽

Pain Medications ◽

Long Term Follow Up ◽

Permanent Implant

Abstract INTRODUCTION Various new waveforms for spinal cord stimulation (SCS) have emerged in recent years, with limited data supporting their utility in a real-world clinical setting. We report real-world results of a protocolized workflow algorithm that allows for high dose (HD) and low dose (LD) neurostimulation in patients with chronic pain undergoing SCS trial or permanent procedures. METHODS Prospective data was collected using the ManageMySurgery (MMS) mobile device platform in patients undergoing Medtronic SCS trial and permanent implant procedures. E-consent was obtained through the HIPAA compliant, mobile software platform. All data was de-identified, aggregated and analyzed. RESULTS In total, 104 patients (37 trial SCS and 67 permanent SCS) participated. For SCS trial and permanent procedures, the protocolized workflow algorithm resulted in a 91% trial success rate with >50% pain relief. At long-term follow-up (3 to 12 mo), 86% of permanent SCS patients reported they were getting the same or more relief as during their SCS trial. For permanent SCS patients, 79% reported >50% improvement in overall pain and 58% had >50% improvement in low back pain. The protocolized workflow algorithm resulted in a 37% “remitter rate,” with these patients reporting themselves essentially pain free (VAS 0–3). Importantly, 52% of permanent implant patients stopped or reduced their ‘as needed’ pain medications by >50%. Additionally, 87% would recommend the same procedure to a friend or family member, 87% found device charging ‘easy’ or ‘very easy’ and 66% reported charging a few times a week or weekly. CONCLUSION A protocolized workflow algorithm that allows for HD and LD neurostimulation appears to have robust utility in providing meaningful pain relief and opiate reduction during both the SCS trial and permanent stages and at longer-term follow-up. Randomized controlled trials with extended follow-up are in progress.

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