Pain reduction in amputees by long-term spinal cord stimulation

1980 ◽  
Vol 52 (3) ◽  
pp. 346-350 ◽  
Author(s):  
Jörg-Ulrich Krainick ◽  
Uwe Thoden ◽  
Traugott Riechert
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Pain Reduction ◽  
Dorsal Column ◽  
Content Type ◽  
Follow Up Study ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ This follow-up study analyzes the results of dorsal column stimulation instituted between 1972 and 1974 for the relief of pain in 84 patients, including 64 amputees. Good results decreased from 52.4% after 2 years of stimulation to 39% after 5 years. Special therapeutic problems in amputees are discussed.

Phantom limb pain

1975 ◽  
Vol 42 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Karl D. Nielson ◽  
John E. Adams ◽  
Yoshio Hosobuchi
Keyword(s):  
Phantom Limb Pain ◽  
Dorsal Column ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Limb Pain ◽  
Content Type ◽  
Successful Series ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ Good to excellent relief of phantom pain is reported in 5 of 6 patients by the use of dorsal column stimulation. Follow-up periods are 7 to 25 months. One failure occurred despite excellent pain relief; this patient could not tolerate application of the DCS apparatus to his chest wall. The authors review the physiology involved and some less successful series reported by others.

Congenital tethered spinal cord syndrome in adults

1998 ◽  
Vol 88 (6) ◽  
pp. 958-961 ◽  
Author(s):  
Bermans J. Iskandar ◽  
Benjamin B. Fulmer ◽  
Mark N. Hadley ◽  
W. Jerry Oakes
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Early Surgery ◽  
Split Cord Malformation ◽  
Tethered Spinal Cord ◽  
Content Type ◽  
Fine Print

Object. The management of tethered spinal cord syndrome with onset of symptomatology occurring in adulthood remains controversial, although the necessity of early surgery in the pediatric tethered cord syndrome population is well established. To ascertain the results of surgery in adult patients with this anomaly, the authors undertook a retrospective review of 34 cases. Methods. The authors studied the hospital records of 34 consecutive patients who presented in adulthood with tethered cord syndrome and conducted follow-up phone interviews with 28 of them. The population consisted of 12 men and 22 women, ranging in age from 18 to 70 years (mean 34 years). The most common presenting feature was pain, followed by weakness and incontinence. All patients underwent surgery. The most common operative findings were tight filum terminale, split cord malformation, and lipomyelomeningocele, paralleling those observed in pediatric studies. Long-term surgical results and patient outcome ratings were encouraging. After a mean clinical follow-up period of 4 years, significant improvement occurred in 22 of 27 patients presenting with pain, 13 of 27 patients with motor or sensory dysfunction, and 11 of 18 patients with bowel and bladder disturbance. In addition, telephone interviews were obtained after a period of 8.6 years. Twenty-two (79%) of 28 patients called the operation a long-term success; 21 (75%) of 28 patients believed that they had significant postoperative improvement (and not just stabilization) in pain and/or neurological function. Surgical complications were generally minor. Nineteen (86%) of 22 employed patients returned to work after surgery. Two (33%) of six patients who were not employed before surgery worked full time postoperatively. Only two of the 28 patients interviewed had received Workers' Compensation benefits; both of these had good outcomes and returned to work. Conclusions. Tethered spinal cord syndrome in adults is an uncommon entity that can become symptomatic. Although surgery in adults involves greater risk of neurological injury than in children, it is a low-risk procedure with encouraging results. Because neurological deficits are generally irreversible, early surgery is recommended.

Supraspinal interactions resulting from experimental dorsal column stimulation

1975 ◽  
Vol 42 (3) ◽  
pp. 296-300 ◽  
Author(s):  
Heinrich Bantli ◽  
James R. Bloedel ◽  
Phudhiphorn Thienprasit
Keyword(s):  
Spinal Cord ◽  
Mechanism Of Action ◽  
Rhesus Monkeys ◽  
Conduction Block ◽  
Dorsal Column ◽  
Content Type ◽  
Spinal Cord Dorsal ◽  
Ascending Pathways ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ Experiments were performed on rhesus monkeys to examine the hypothesis that stimulation with dorsal column electrodes of the type implanted clinically could alter the responses evoked in supraspinal nuclei through pathways in the ventral quadrant of the spinal cord. Dorsal column stimulation did produce changes in responses evoked in supraspinal nuclei; this effect could not be ascribed to a conduction block in ascending pathways. These results suggest that the mechanism of action of the dorsal column stimulator need not be dependent on interactions in the dorsal horn.

Long-term results after lateral canthal advancement for unilateral coronal synostosis

1992 ◽  
Vol 76 (3) ◽  
pp. 401-407 ◽  
Author(s):  
Helio R. Machado ◽  
Harold J. Hoffman
Keyword(s):  
Continuous Improvement ◽  
Long Term Results ◽  
Successful Result ◽  
Content Type ◽  
Follow Up Study ◽  
Coronal Synostosis ◽  
Sick Children ◽  
Fine Print

✓ The procedure of lateral canthal advancement was carried out to correct unilateral coronal synostosis in 39 consecutive patients at The Hospital for Sick Children during a 20-year period. Thirty-seven children were available for follow-up study, and results were considered to be good or excellent in 81% of them. Liberation of the supraorbital margin and release of stenotic skull base sutures are crucial for a successful result. The severity of the process and the age of the patient were not restrictive factors in regard to indication for this procedure. Some patients showed a continuous improvement with time. Morbidity was minimal. It is suggested that lateral canthal advancement is the procedure of choice for unilateral coronal synostosis.

Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review

2004 ◽  
Vol 100 (3) ◽  
pp. 254-267 ◽  
Author(s):  
Tracy Cameron
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Literature Review ◽  
Spinal Cord Stimulation ◽  
Exclusion Criteria ◽  
Safety And Efficacy ◽  
Content Type ◽  
Long Term Effect ◽  
Fine Print

Object. The purpose of this report was to examine the available literature to determine the safety and efficacy of spinal cord stimulation (SCS) for the treatment of chronic pain of the trunk and limbs. Methods. The author identified 68 studies that fulfilled the efficacy inclusion/exclusion criteria, grouped on the basis of pain indication, with an overall population of 3679 patients. Fifty-one studies fulfilled all safety inclusion/exclusion criteria. Based on the literature review, the author found that SCS had a positive, symptomatic, long-term effect in cases of refractory angina pain, severe ischemic limb pain secondary to peripheral vascular disease, peripheral neuropathic pain, and chronic low-back pain, and that, in general, SCS was a safe and effective treatment for a variety of chronic neuropathic conditions. Conclusions. Despite the positive findings, there is an urgent need for randomized, controlled, long-term studies on the efficacy of SCS involving larger patient sample sizes.

Long-Term Multicolumn-Lead Spinal Cord Stimulation Efficacy in Patients with Failed Back Surgery Syndrome: A Six-Year Prospective Follow-up Study

2020 ◽  
Vol 142 ◽  
pp. e245-e252 ◽  
Author(s):  
Thibault Remacle ◽  
Stephane Mauviel ◽  
Henri-Jean Renwart ◽  
Keyvan Ghassempour ◽  
Frederic Belle ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Failed Back Surgery Syndrome ◽  
Follow Up Study ◽  
Failed Back Surgery ◽  
Back Surgery

Electrical spinal cord stimulation in reflex sympathetic dystrophy: retrospective analysis of 23 patients

1999 ◽  
Vol 90 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Marius A. Kemler ◽  
Gerard A. M. Barendse ◽  
Maarten Van Kleef ◽  
Frans A. J. M. Van Den Wildenberg ◽  
Wilhelm E. J. Weber
Keyword(s):  
Spinal Cord ◽  
Pain Score ◽  
Spinal Cord Stimulation ◽  
Reflex Sympathetic Dystrophy ◽  
Clinical Status ◽  
Test Period ◽  
The Other ◽  
Content Type ◽  
Fine Print

Object. The aim of the study was to assess retrospectively the clinical efficacy and possible adverse effects of electrical spinal cord stimulation (SCS) for the treatment of patients with reflex sympathetic dystrophy (RSD). Methods. Twenty-three patients who suffered severe pain due to RSD were included in the study. The SCS system was implanted only after a positive 1-week test period. The visual analog scale (VAS) score for pain (1–10) was obtained in all patients prior to treatment, 1 month postimplantation, and at last follow up. At final follow-up examination, patients were asked to rate the effect of their treatment on the 7-point global perceived effect scale. Eighteen (78%) of 23 patients treated between 1991 and 1997 reported improvement during the test period. Permanent implantation of SCS system was not performed in the other five patients. Complications occurred in nine (50%) of 18 patients. The system was removed in three patients after implantation (17%). At the end of follow up (mean 32 months) 15 patients still had an implanted system. The mean pain score had decreased from 7.9 to 5.4 (p < 0.001). In the other eight patients the pain score had not changed significantly. In 13 patients (57%) in whom the SCS system was implanted, clinical status had much improved or improved; these cases were regarded as successful. Conclusions. In this retrospective series, the majority of patients with RSD reported a subjective improvement after implantation of an SCS system.

Improvement of limb circulation in peripheral vascular disease using epidural spinal cord stimulation: a prospective study

1997 ◽  
Vol 86 (4) ◽  
pp. 662-669 ◽  
Author(s):  
Krishna Kumar ◽  
Cory Toth ◽  
Rahul K. Nath ◽  
Ashok K. Verma ◽  
John J. Burgess
Keyword(s):  
Spinal Cord ◽  
Blood Flow ◽  
Vascular Disease ◽  
Spinal Cord Stimulation ◽  
Long Term Outcome ◽  
Content Type ◽  
Good Outcome ◽  
Peak Blood ◽  
Fine Print

✓ Spinal cord stimulation was used in 46 patients for pain associated with lower extremity ischemic vascular disease that was considered to be nonreconstructable. Thirty-nine patients who had a follow-up examination between 2 and 36 months after the procedure form the basis of this report. Thirty (77%) of 39 cases were considered successful. Clinical endpoints indicating failure included amputation, vascular reconstruction, poor pain relief, or hardware malfunction. The transcutaneous partial pressure of oxygen (TcPO2) increased in both target and control feet. In patients with good outcome with a preimplantation TcPO2 of less than 30 mm Hg, TcPO2 increased significantly (p < 0.05). Pulse volume recording improved significantly (p < 0.05) at the thigh, metatarsal, and great toe levels in successfully treated patients. Peak blood flow velocity also showed a significant increase in patients with good outcome (p < 0.05). Patients with a TcPO2 of less than 10 mm Hg following stimulation tended to undergo amputation within the first 3 months. Improvement in pain control, combined with an increase in TcPO2 values that was greater than 10 mm Hg, were significant early predictors of long-term success. An initial increase in peak blood flow velocities (measured in Doppler studies) of greater than 10 mm also signified a good long-term outcome. Spinal cord stimulation appears to be a useful therapeutic modality for controlling pain and improving perfusion in a select group of patients with end-stage ischemic vascular disease considered nonreconstructable. The best results were seen in patients with severe claudication and rest pain without trophic changes in the foot. The mechanism of this beneficial effect is not yet completely understood.

Long-term results of Gasserian ganglion electrocoagulation

1975 ◽  
Vol 42 (2) ◽  
pp. 140-143 ◽  
Author(s):  
Jürgen Menzel ◽  
Wolfgang Piotrowski ◽  
Helmut Penzholz
Keyword(s):  
Trigeminal Neuralgia ◽  
Long Term Results ◽  
Gasserian Ganglion ◽  
Content Type ◽  
Follow Up Study ◽  
Fine Print

✓ This report is a follow-up study of 315 patients under 46 years old who suffered from trigeminal neuralgia and were treated by electrocoagulation of the Gasserian ganglion. The average follow-up period was 12.7 years, the maximum 33 years. Eighty percent had a return of pain, but 96.7% ultimately attained freedom from pain after repeat electrocoagulation.

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