High-frequency spinal cord stimulation in treatment of phantom lower limb pain following spinal cord injury: A case report.

Introduction: Pain management in patients with complete spinal cord injury is complex.

Case Report: We report a successful case of managing neuropathic, phantom limb, and back pain below the level of spinal cord injury (T5 American Spinal Injury Association [ASIA] A) using a 10 kHz high-frequency spinal cord stimulator (SCS) over a 6-month follow-up period.

Conclusion: The effectiveness of this approach may be attributed to its ability to modulate supraspinal pain processing, allowing for targeted relief of various pain mechanisms below the level of injury.

Anchoring of a mental nerve stimulator for treatment of facial neuropathic pain: a case illustration.

Introduction: Mental nerve stimulation is recognised as a treatment option for neuropathic facial pain. Historically however, lead migration across the mobile temporomandibular joint has prevented this procedures utility.

Methods: We describe a new method of insertion and anchoring of a mental nerve stimulator for the management of refractory neuropathic pain in the distribution of the mental nerve.

ECAP-Controlled Closed-Loop Spinal Cord Stimulation Efficacy and Opioid Reduction Over 24-Months: Final Results of the Prospective, Multicenter, Open-Label Avalon Study.

Introduction: Chronic pain is a major public health concern, as is the associated use of opioid medications, highlighting the importance of alternative treatments, such as spinal cord stimulation (SCS). Here, we present the final 24-month results of the Avalon study, which investigated the use of the first closed-loop SCS system in patients with chronic pain. The system measures the evoked compound action potentials (ECAPs) elicited by each stimulus pulse and drives a feedback loop to maintain the ECAP amplitude near constant.

Sustained Long-Term Outcomes With Closed-Loop Spinal Cord Stimulation: 12-Month Results of the Prospective, Multicenter, Open-Label Avalon Study.

Background: Spinal cord stimulation (SCS) activates the dorsal column fibers using electrical stimuli. Current SCS systems function in fixed-output mode, delivering the same stimulus regardless of spinal cord (SC) activation.

Objective: To present long-term outcomes of a novel closed-loop SCS system that aims to maintain the SC activation near a set target level and within a therapeutic window for each patient.

Effective Relief of Pain and Associated Symptoms With Closed-Loop Spinal Cord Stimulation System: Preliminary Results of the Avalon Study.

Objectives: Conventional spinal cord stimulation (SCS) delivers a fixed-input of energy into the dorsal column. Physiologic effects such as heartbeat, respiration, spinal cord movement, and history of stimulation can cause both the perceived intensity and recruitment of stimulation to increase or decrease, with clinical consequences. A new SCS system controls stimulation dose by measuring the recruitment of fibers in the dorsal column and by using the amplitude of the evoked compound action potentials (ECAPs) to maintain stimulation within an individualized therapeutic range.