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Background: Recently, there has been a burgeoning interest in the utility of peripheral nerve stimulation (PNS) for a variety of chronic focal neuropathic, musculoskeletal and visceral pain conditions. If the source of pain is directly related to a single peripheral nerve, surgical exposure and placing a paddle lead on the nerve are most effective.
Methods: In this report, we describe a novel technique that optimizes the peripheral nerve stimulation by two paddle leads placed on either side of the nerve with their stimulating surfaces in contact with the nerve. After appropriate prepping and draping, the selected nerve is localized and circumferentially dissected free from the adjacent soft tissue. There should be enough length of nerve to accommodate two On-Point quadripolar leads (Medtronic, MN) along the length of the nerve in the same direction.
Results: This 'sandwich' technique provides a wider interface of contacts with nerve fibers. It reduces the chance of migration and provides an opportunity for 'crosstalk.'
Conclusion: In selected cases where an open surgical PNS lead needs to be placed, the 'sandwich' technique can be used to augment the stimulation without additional morbidity. Although occasionally used in practice, this technique is still unreported.
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http://dx.doi.org/10.1007/s00701-014-2208-4 | DOI Listing |
Oncologist
December 2024
The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW 2010, Australia.
Background: TRK-inhibitors have demonstrated efficacy across several cancers with NTRK fusions. Their activity in cancers with NTRK overexpression remains unclear.
Methods: This trial enrolled patients with advanced cancers harboring NTRK fusions or extreme mRNA overexpression, defined as NTRK1/2/3 expression by RNA profiling >5 SDs for a given cancer type.
Thorac Cardiovasc Surg Rep
January 2024
Department of Adult and Pediatric Cardiac and Vascular Surgery, University Hospital Giessen and Marburg Campus Giessen, Giessen, Hessen, Germany.
Minimally invasive lateral thoracotomies may cause severe postoperative pain and discomfort. We describe an intraoperative intercostal cryo-neuronal pain block as one possibility for postoperative pain relief. A 63-year-old male patient underwent minimally invasive mitral valve repair.
View Article and Find Full Text PDFFront Oncol
December 2024
Nursing Department, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Introduction: Peripheral neuropathy is a nerve disorder that causes pain, numbness, and tingling in different parts of the body. It is a major and common clinical problem associated with several chemotherapeutic medications frequently used in cancer treatment, with prevalence rates ranging from 19% to 85%. To the best of the authors' knowledge, there is a lack of data on the magnitude and determinants of chemotherapy-induced peripheral neuropathy in Ethiopia.
View Article and Find Full Text PDFFront Neurosci
December 2024
Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States.
Objective: Targeted transcutaneous electrical nerve stimulation (tTENS) is a non-invasive neural stimulation technique that involves activating sensory nerve fibers to elicit tactile sensations in a distal, or referred, location. Though tTENS is a promising approach for delivering haptic feedback in virtual reality or for use by those with somatosensory deficits, it was not known how the perception of tTENS might be influenced by changing wrist position during sensorimotor tasks.
Approach: We worked with 12 able-bodied individuals and delivered tTENS by placing electrodes on the wrist, thus targeting the ulnar, median, and radial nerves, and eliciting tactile sensations in the hand.
J Med Life
October 2024
Johns Hopkins Aramco Healthcare, Department of Pathology, Dhahran, Saudi Arabia.
Schwannomas are peripheral nerve sheath tumors that rarely arise from autonomic nerves of the pleural lining. Most often, they present as slow-growing tumors and are asymptomatic. Herein, we describe the case of an elderly male patient who presented with severe chest pain.
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