Cost-effectiveness and Safety of Interspinous Process Decompression (Superion).

Objective: There are several treatment options for patients suffering from lumbar spinal stenosis, including surgical and conservative care. Interspinous spacer decompression using the Superion device offers a less invasive procedure for patients who fail conservative treatment before traditional decompression surgery. This review assesses the current cost-effectiveness, safety, and performance of lumbar spinal stenosis treatment modalities compared with the Superion interspinous spacer procedure.

Interspinous Process Decompression With The Superion Spacer For Lumbar Spinal Stenosis: Real-World Experience From A Device Registry.

Background: Interspinous process decompression (IPD) with stand-alone spacers has demonstrated excellent long-term clinical benefit for patients with lumbar spinal stenosis (LSS).

Methods: IPD used the Superion Indirect Decompression System (Vertiflex, Carlsbad, CA, USA). Perioperative and clinical data were captured via a registry for patients treated with IPD for LSS with intermittent neurogenic claudication.

Spinal Cord Stimulation (SCS) with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain Relief Compared to Traditional SCS-LUMINA Study.

Background: The aim of this study was to determine whether spinal cord stimulation (SCS) using 3D neural targeting provided sustained overall and low back pain relief in a broad routine clinical practice population.

Study Design And Methods: This was a multicenter, open-label observational study with an observational arm and retrospective analysis of a matched cohort. After IPG implantation, programming was done using a patient-specific, model-based algorithm to adjust for lead position (3D neural targeting) or previous generation software (traditional).

Percutaneous Rupture of a Symptomatic Facet Joint Synovial Cyst Using 2-Needle Distention.

Objective: This case report calls attention to an alternative approach for management of a symptomatic facet joint synovial cyst. We describe a patient with a symptomatic facet joint synovial cyst who failed an attempted percutaneous rupture using a single-needle technique. This patient was subsequently successfully managed with percutaneous rupture using a 2-needle technique.

Peripheral nerve field stimulation for the management of localized chronic intractable back pain: results from a randomized controlled study.

Objectives: Improved device technology has caused a renewed interest in peripheral nerve field stimulation (PNfS). This study sought to obtain preliminary estimates of the safety and efficacy of PNfS in patients with localized chronic intractable pain of the back.

Materials And Methods: This Institutional Review Board-approved, prospective, randomized, controlled, crossover study consisted of two phases.

Stimulation of the peripheral nervous system for the painful extremity.

Peripheral nerve stimulation and, recently, peripheral nerve field stimulation are excellent options for the control of extremity pain in instances where conventional methods have failed and surgical treatment is ruled inappropriate. New techniques, ultrasound guidance, smaller generators, and task-specific neuromodulatory hardware and leads result in increasingly safe, stable and efficacious treatment of pain in the extremities. Peripheral nerve stimulation has shown to be an increasingly viable option for many painful conditions with neuropathic and possibly nociceptive origins.

Peripheral nerve stimulation for the treatment of truncal pain.

Neuromodulation practitioners increasingly recognize the potential for peripheral nerve field stimulation (PNfS) to treat pain originating from the trunk. Conditions resulting in truncal pain that may respond to PNfS include cervical and lumbar postlaminectomy syndrome, inguinal neurapraxia, post-herpetic neuralgia, and post-thoracotomy pain. The focus of this chapter is to review the mechanism of action in PNfS, patient selection factors, programming strategies, and technical considerations.

Cervical nerve root stimulation. Part I: technical aspects and normal data.

Objective: Cervical nerve root stimulation (CRS) is a technique of assessing the proximal segments of motor axons destined to upper extremity muscles. Few studies report normal values. The objective was to determine CMAP onset-latencies and CMAP amplitude, area, and duration changes in healthy controls for the abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps, and riceps muscles.

Neurophysiologic findings in early acute inflammatory demyelinating polyradiculoneuropathy.

Background: Patients with early acute inflammatory demyelinating polyradiculoneuropathy (AIDP) may not meet the current neurophysiologic criteria.

Objective: To document neurophysiologic findings in early AIDP.

Methods: Clinical and neurophysiologic data from 38 AIDP patients, assessed within 10 days of symptom onset were reviewed.

Effects of treadmill walking speed on lateral gastrocnemius muscle firing.

Objective: To study the electromyographic profile--including ON, OFF, and peak timing locations--of the lateral gastrocnemius muscle over a wide range of walking speeds (0.5-2.1 m/sec) in healthy young adults.

PoWER Program: People with Disabilities Educating Residents.

An educational program was developed incorporating people with disabilities (PWDs) as "consumer-trainers" who educate physical medicine and rehabilitation residents about challenges in everyday living and their solutions to these. During the residency postgraduate years 2 and 4, pairs of residents visited trainers in their homes and at their jobs to learn about their lifestyles and adaptations. Residents' described the experience as "excellent, outstanding, invaluable" in more than half of the evaluations.

Growth factors and stem cells as treatments for stroke recovery.

Both polypeptide growth factors and stem cell populations from bone marrow and umbilical cord blood hold promise as treatments to enhance neurologic recovery after stroke. Growth factors may exert their effects through stimulation of neural sprouting and enhancement of endogenous progenitor cell proliferation, migration, and differentiation in brain. Exogenous stem cells may exert their effects by acting as miniature "factories" for trophic substances in the poststroke brain.

Influence of poststroke urinary incontinence on disability: the nursing home setting.

Objective: To characterize the association of poststroke urinary incontinence with disability progression in nursing home residents.

Design: In this prospective cohort study, the Minimum Data Set from the State of New York between 1994 and 1997 was utilized. From a pool of over 240,000 potential subjects, 500 met inclusion/exclusion criteria.

Motor function improvement following intrathecal baclofen pump placement in a patient with locked-in syndrome.

We describe a patient with locked-in syndrome who had minimal volitional motor function and severe spasticity in all four extremities. The patient showed a significant improvement in volitional motor function following intrathecal baclofen pump therapy to control spasticity. This case study suggests that intrathecal baclofen pump therapy might improve motor function in select patients with locked-in syndrome.