Two-Year Outcomes Using Fast-Acting, Sub-Perception Therapy for Spinal Cord Stimulation: A European, Real-World, Multicenter Experience.

Over the last 20 years, spinal cord stimulation (SCS) has seen the development of various paresthesia-free paradigms. Recently, a novel modality has emerged (Fast-Acting Sub-perception Therapy, FAST) that engages the surrounding inhibition mechanism of action. We evaluated long-term, real-world outcomes of preferential FAST-SCS use in patients with chronic pain.

Evaluating the Readability, Quality, and Reliability of Online Patient Education Materials on Spinal Cord Stimulation.

Aim: To obtain health-related information internet usage is rapidly increasing. However, there are concerns about the comprehensibility and reliability of internet-accessed health-related information. The aim of this research was to investigate the reliability, quality, and readability of patient education materials (PEMs) about spinal cord stimulation (SCS) on the internet.

10 kHz stimulation as rescue therapy for spinal cord stimulation trial failure or loss of efficacy: A retrospective study.

Introduction: Spinal cord stimulation (SCS) is currently used for the management of pain of different origin, and since its inception, many waveforms have been developed. Some patients experience no pain relief already during SCS trial, while other patients go through a loss of efficacy due to habituation after a variable period of satisfying pain control. Our retrospective study represents the first report exploring the potential role of 10 kHz stimulation as rescue therapy for patients who did not benefit not only from conventional stimulation but even from other waveforms during SCS trial or follow-up.

Improved Outcomes and Therapy Longevity after Salvage Using a Novel Spinal Cord Stimulation System for Chronic Pain: Multicenter, Observational, European Case Series.

Spinal cord stimulation (SCS) is proven to effectively relieve chronic neuropathic pain. However, some implanted patients may face loss of efficacy (LoE) over time, and conversion to more recent devices may rescue SCS therapy. Recent SCS systems offer novel stimulation capabilities, such as temporal modulation and spatial neural targeting, and can be used to replace previous neurostimulators without changing existing leads.

Incidence and Management of Hardware-Related Wound Infections in Spinal Cord, Peripheral Nerve Field, and Deep Brain Stimulation Surgery: A Single-Center Study.

Introduction: Neuromodulation using deep brain stimulation (DBS), spinal cord stimulation (SCS), and peripheral nerve field stimulation (PNFS) to treat neurological, psychiatric, and pain disorders is a rapidly growing field. Infections related to the implanted hardware are among the most common complications and result in health-related and economic burden. Unfortunately, conservative medical therapy is less likely to be successful.

Dose escalation in intrathecal baclofen therapy based on disease etiology: Can an target dose be established? A ten-year follow-up study.

Context: Intrathecal baclofen (ITB) therapy is administered for severe, persistent spasticity that cannot be addressed by oral medication or other treatments.

Objective: We aimed to evaluate the target dose of ITB for severe, persistent spasticity based on disease etiology.

Methods: Data at baseline (discharge), 1, and 10 years from 102 patients who received ITB therapy between 1985 and 2011 were retrospectively collected.

Real-world outcomes of single-stage spinal cord stimulation in chronic pain patients: A multicentre, European case series.

Background: Spinal cord stimulation (SCS) is effective in treating chronic neuropathic pain. A screening trial is typically conducted prior to implantation to evaluate whether a patient is a good candidate for SCS. However, the need for a screening trial has been debated.

Spinal cord stimulation as a treatment option for complex regional pain syndrome: a narrative review.

: This review aims to analyze the last years' experience of applying spinal cord stimulation (SCS) in complex regional pain syndrome (CRPS) patients with persistent or refractory chronic pain. : This is a narrative review which was executed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was carried out through the following databases: PUBMED and Cochrane Library. Also, a search for trials in the metaRegister of controlled trials (www.

Clinical utilization of fast-acting sub-perception therapy (FAST) in SCS-implanted patients for treatment of mixed pain.

Objectives: A significant proportion of patients with chronic pain exhibit mixed pain and thus do not display symptoms exclusively associated with either nociceptive or neuropathic pain syndromes. We aimed to explore whether Fast-Acting Sub-Perception Therapy, FAST - a new Spinal Cord Stimulation (SCS)-based approach capable of inducing a rapid-onset of analgesia using electrical neurostimulation applied below patient-perception threshold - could potentially be useful as a treatment for chronic mixed pain.

Methods: Fourteen consecutively-enrolled patients diagnosed with chronic mixed pain and implanted with an SCS device were enrolled in this single-center case-series.

[Burnout and dependence among medical personnel timeless and during the COVID-19 pandemic, using surgery and anesthesia as examples].

Background: The COVID-19 pandemic affects the mental health and professional behavior of surgeons and anesthesiologists and seems to have an impact on substance dependence.

Question: What are the reasons for the occurrence of substance dependence and burnout in surgeons and anesthesiologists timelessly and during the COVID-19 pandemic and what improvement measures could help in the clinical practice?

Material And Methods: A literature search was conducted in the form of a systematic review of studies and review articles relevant to the topic.

Results: Over the years it has been shown that surgeons and anesthesiologists are prone to drug dependence due to their direct access to medications in the clinical field and work-related stress.

Epidural electrical spinal cord stimulation of the thoracic segments (T2-T5) facilitates respiratory function in patients with complete spinal cord injury.

Introduction: Patients with high cervical Spinal Cord Injury (SCI) usually require mechanical ventilation support. Phrenic Nerve Stimulation (PNS) both direct and indirect is the main alternative for these patients to wean off ventilator although PNS has several limitations and phrenic nerve could be also damaged after cervical spinal cord injury.

Objective: In this study, we assessed if the spinal cord Epidural Electrical Stimulation (EES) at the segments T2-T5, related to intercostal muscles, can facilitate respiratory function and particularly inspired tidal volume during mechanic ventilation.

A Retrospective Analysis of Intrathecal Catheter Tip Position in Plain Radiography: How Much Do We Agree?

Aim: To assess interrater and intrarater reliability of postoperative plain radiographs, which are routinely performed to confirm the correct placement of the catheter tip after intrathecal drug delivery systems (IDDS) implantation.

Material And Methods: This was a retrospective analysis of plain radiographs obtained from patients implanted with intrathecal catheters and morphine pumps. Each plain radiograph was assessed independently by three raters with varying expertise, at three different time points, to confirm the position of the intrathecal catheter tip.

Spinal cord stimulation in the treatment of peripheral vascular disease: a systematic review - revival of a promising therapeutic option?

Introduction: Peripheral vascular disease (PVD) is caused by a blood circulation disorder of the arteries and Critical Limb Ischemia (CLI) is the advanced state of PVD. For patients with surgically non-reconstructable CLI, Spinal Cord Stimulation (SCS) appears to be an alternative therapeutic option.

Objective: The aim of our study was to investigate the efficacy of SCS in non-reconstructable CLI compared with the conservative treatment and re-appraise the existing literature in light of the recent advances in neuromodulation.

Intrathecal pain management with ziconotide: Time for consensus?

This article summarizes recommendations made by six pain specialists who discussed the rationale for ziconotide intrathecal analgesia (ITA) and the requirement for evidence-based guidance on its use, from a European perspective. Riemser Pharma GmbH (Greifswald, Germany), which holds the European marketing authorization for ziconotide, hosted the meeting. The group agreed that ITA is under-used in Europe, adding that ziconotide ITA has potential to be a first-line alternative to morphine; both are already first-line options in the USA.

1.2 kHz High-Frequency Stimulation as a Rescue Therapy in Patients With Chronic Pain Refractory to Conventional Spinal Cord Stimulation.

Objectives: We aimed to investigate the efficacy of new subperception stimulation paradigms including 1.2 kHz-high-frequency stimulation (HFS) and advanced-HFS field-shaping algorithm (dorsal horn HFS [DHHFS]) in refractory cases which initially benefited from conventional spinal cord stimulation (SCS) and lost the effect throughout time.

Materials And Methods: In the context of a rescue-therapy, patients underwent externalization of the implanted SCS-leads and were tested with multiple combinations of new SCS paradigms.

Prediction of Lumbar Disc Herniation Patients' Satisfaction with the Aid of an Artificial Neural Network.

Aim: To identify key determinants of lumbar disc herniation (LDH) patients' satisfaction and to evaluate the efficiency of an artificial neural network (ANN) model to prognosticate satisfaction derived from the hospital stay in this specific patient group.

Material And Methods: A single item question was used to assess patient satisfaction. Principal component analysis evaluated several aspects of care (15 items).

An atypical meningioma demystified and advanced magnetic resonance imaging techniques.

A 40-year-old male presented with visuospatial processing disturbances. Family history was free. Conventional and advanced magnetic resonance imaging (MRI) studies were performed.

Is there a Role for Spect with (99m)Tc-Tetrofosmin in the Diagnostic Work Up of a Brain Tumor?

Brain MRI is the gold standard for diagnosis of brain tumors. In some cases preoperative MRI cannot predict the grade of malignancy, diagnostic information that could be very helpful to the surgeon. In such cases functional imaging with nuclear medicine techniques may prove quite useful.

Spinal arteriovenous fistula with progressive paraplegia after spinal anaesthesia.

A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years.

Silicone models as basic training and research aid in endovascular neurointervention--a single-center experience and review of the literature.

The rapid development and wider use of neurointerventional procedures have increased the demand for a comprehensive training program for the trainees, in order to safely and efficiently perform these procedures. Artificial vascular models are one of the dynamic ways to train the new generation of neurointerventionists to acquire the basic skills of material handling, tool manipulation through the vasculature, and development of hand-eye coordination. Herein, the authors present their experience regarding a long-established training program and review the available literature on the advantages and disadvantages of vascular silicone model training.