Name: treating low back pain in failed back surgery patients with multicolumn-lead spinal cord stimulation
Uploaded: 2018-06-26T12:30:00
Description: Watch this Scientific Journal Video about Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation at JoVE.com

Forfatterne vil gjerne takke Gabrielle Leyden for revidere det siste utkastet dette papiret.

1. pasienten valg
<ol><li>Kontroller diagnosen FBSS20.</li>
	<li>
Pass på at FBSS pasienten oppfyller alle inklusjonskriterier før de blir akseptert for en SCS prøveversjon:
	<ol>
<li>Kroniske ryggsmerter og/eller radicular smerter som var ildfaste til optimal medisinsk behandling i minst 6 måneder.</li>
		<li>Vedvarende smerte til tross for 3 typer farmakologiske behandlinger (paracetamol, ikke-steroide antiinflammatoriske legemidler, opioider, Antidepressiva medisiner, ant...

<ol>
	<li>Schofferman, J., Reynolds, J., Herzog, R., Covington, E., Dreyfuss, P., O'Neill, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Failed+back+surgery:+Etiology+and+diagnostic+evaluation.">Failed back surgery: Etiology and diagnostic evaluation.</a> Spine Journal. 3 (5), 400-403 (2003).</li><li>Hazard, R. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Failed+back+surgery+syndrome:+surgical+and+nonsurgical+approaches.">Failed back surgery syndrome: surgical and nonsurgical approaches.</a> Clinical Orthopaedics and Related Research. 443 (443), 228-232 (2006).</li><li>Rigoard, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+Algorithmic+Programming+Approach+for+Back+Pain+Symptoms+in+Failed+Back+Surgery+Syndrome+Using+Spinal+Cord+Stimulation+with+a+Multicolumn+Surgically+Implanted+Epidural+Lead:+A+Multicenter+International+Prospective+Study.">An Algorithmic Programming Approach for Back Pain Symptoms in Failed Back Surgery Syndrome Using Spinal Cord Stimulation with a Multicolumn Surgically Implanted Epidural Lead: A Multicenter International Prospective Study.</a> Pain Practice. 15 (3), 195-207 (2015).</li><li>Thomson, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Failed+back+surgery+syndrome+-+definition,+epidemiology+and+demographics.">Failed back surgery syndrome - definition, epidemiology and demographics.</a> British Journal of Pain. 7 (1), 56-59 (2013).</li><li>Balagu&#233;, F., Mannion, A. F., Pellis&#233;, F., Cedraschi, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-specific+low+back+pain.">Non-specific low back pain.</a> Lancet. 379 (9814), 482-491 (2012).</li><li>Melzack, R., Wall, P. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pain+Mechanisms:+A+New+Theory.">Pain Mechanisms: A New Theory.</a> Science. 150 (3699), 971-979 (1965).</li><li>Gonz&#225;lez, J. C. A., Melzack, R., Wall, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+gate+theory:+Beyond+the+scientific+concept+two+worlds+scientists+dedicated+to+the+understanding+of+pain.">The gate theory: Beyond the scientific concept two worlds scientists dedicated to the understanding of pain.</a> Revista de la Sociedad Espanola del Dolor. 20 (4), 191-202 (2013).</li><li>Loeser, D., John, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concepts+of+pain.">Concepts of pain.</a> The Lancet. 353 (May 8), 1607-1609 (1992).</li><li>Cui, J. G., Linderoth, B., Meyerson, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+spinal+cord+stimulation+on+touch-evoked+allodynia+involve+GABAergic+mechanisms.+An+experimental+study+in+the+mononeuropathic+rat.">Effects of spinal cord stimulation on touch-evoked allodynia involve GABAergic mechanisms. An experimental study in the mononeuropathic rat.</a> Pain. 66 (2-3), 287-295 (1996).</li><li>Song, Z., Meyerson, B. A., Linderoth, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Muscarinic+receptor+activation+potentiates+the+effect+of+spinal+cord+stimulation+on+pain-related+behavior+in+rats+with+mononeuropathy.">Muscarinic receptor activation potentiates the effect of spinal cord stimulation on pain-related behavior in rats with mononeuropathy.</a> Neuroscience Letters. 436 (1), 7-12 (2008).</li><li>Song, Z., Meyerson, B. A., Linderoth, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spinal+5-HT+receptors+that+contribute+to+the+pain-relieving+effects+of+spinal+cord+stimulation+in+a+rat+model+of+neuropathy.">Spinal 5-HT receptors that contribute to the pain-relieving effects of spinal cord stimulation in a rat model of neuropathy.</a> Pain. 152 (7), 1666-1673 (2011).</li><li>Waszak, P. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spinal+Cord+Stimulation+in+Failed+Back+Surgery+Syndrome:+Review+of+Clinical+Use,+Quality+of+Life+and+Cost-effectiveness.">Spinal Cord Stimulation in Failed Back Surgery Syndrome: Review of Clinical Use, Quality of Life and Cost-effectiveness.</a> Asian Spine Journal. 10 (6), 1195-1204 (2016).</li><li>Kishima, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulation+of+neuronal+activity+after+spinal+cord+stimulation+for+neuropathic+pain;+H(2)15O+PET+study.">Modulation of neuronal activity after spinal cord stimulation for neuropathic pain; H(2)15O PET study.</a> Neuroimage. 49 (2), 2564-2569 (2010).</li><li>Stanc&#225;k, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+magnetic+resonance+imaging+of+cerebral+activation+during+spinal+cord+stimulation+in+failed+back+surgery+syndrome+patients.">Functional magnetic resonance imaging of cerebral activation during spinal cord stimulation in failed back surgery syndrome patients.</a> European Journal of Pain (London, England). 12 (2), 137-148 (2008).</li><li>Yang, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bipolar+spinal+cord+stimulation+attenuates+mechanical+hypersensitivity+at+an+intensity+that+activates+a+small+portion+of+A-fiber+afferents+in+spinal+nerve-injured+rats.">Bipolar spinal cord stimulation attenuates mechanical hypersensitivity at an intensity that activates a small portion of A-fiber afferents in spinal nerve-injured rats.</a> Neuroscience. 199, 470-480 (2011).</li><li>North, R. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spinal+cord+stimulation+versus+re-operation+in+patients+with+failed+back+surgery+syndrome:+an+international+multicenter+randomized+controlled+trial+(EVIDENCE+study).">Spinal cord stimulation versus re-operation in patients with failed back surgery syndrome: an international multicenter randomized controlled trial (EVIDENCE study).</a> Neuromodulation: Journal of the International Neuromodulation Society. 14, 330-335 (2011).</li><li>Kapural, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+10-kHz+High-Frequency+and+Traditional+Low-Frequency+Spinal+Cord+Stimulation+for+the+Treatment+of+Chronic+Back+and+Leg+Pain:+24-Month+Results+From+a+Multicenter,+Randomized,+Controlled+Pivotal+Trial.">Comparison of 10-kHz High-Frequency and Traditional Low-Frequency Spinal Cord Stimulation for the Treatment of Chronic Back and Leg Pain: 24-Month Results From a Multicenter, Randomized, Controlled Pivotal Trial.</a> Neurosurgery. 79 (5), 667-677 (2016).</li><li>Remacle, T. Y., Bonhomme, V. L., Renwart, H. J. P., Remacle, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+Multicolumn+Lead+Spinal+Cord+Stimulation+on+Low+Back+Pain+in+Failed+Back+Surgery+Patients:+A+Three-Year+Follow-Up.">Effect of Multicolumn Lead Spinal Cord Stimulation on Low Back Pain in Failed Back Surgery Patients: A Three-Year Follow-Up.</a> Neuromodulation: Technology at the Neural Interface. 20 (7), 668-674 (2017).</li><li>Veizi, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spinal+Cord+Stimulation+(SCS)+with+Anatomically+Guided+(3D)+Neural+Targeting+Shows+Superior+Chronic+Axial+Low+Back+Pain+Relief+Compared+to+Traditional+SCS-LUMINA+Study.">Spinal Cord Stimulation (SCS) with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain Relief Compared to Traditional SCS-LUMINA Study.</a> Pain Medicine (Malden, Mass). 18 (8), 1534-1548 (2017).</li><li>Chan, C., Peng, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Failed+back+surgery+syndrome.">Failed back surgery syndrome.</a> Pain Medicine. 12 (4), 577-606 (2011).</li><li>Hawker, G., Mian, S., Kendzerska, T., French, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measures+of+adult+pain.">Measures of adult pain.</a> Arthritis Care and Research. 63 (11), 240-252 (2011).</li><li>Deer, T. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Neurostimulation+Appropriateness+Consensus+Committee+(NACC)+Safety+Guidelines+for+the+Reduction+of+Severe+Neurological+Injury.">The Neurostimulation Appropriateness Consensus Committee (NACC) Safety Guidelines for the Reduction of Severe Neurological Injury.</a> Neuromodulation. 20 (1), 15-30 (2017).</li><li>Gupta, P., Kumar, A., Kumar, A., Goel, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Congenital+Spinal+Cord+Anomalies:+A+Pictorial+Review.">Congenital Spinal Cord Anomalies: A Pictorial Review.</a> Current Problems in Diagnostic Radiology. 42 (2), 57-66 (2013).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Medtronic N'VISION&#174; Programmer Quick Guide. , (2009).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Medtronic MyStim&#174; Programmer Quick Guide. , (2014).</li><li>Frey, M. E., Manchikanti, L., Benyamin, R. M., Schultz, D. M., Smith, H. S., Cohen, S. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spinal+cord+stimulation+for+patients+with+failed+back+surgery+syndrome:+a+systematic+review.">Spinal cord stimulation for patients with failed back surgery syndrome: a systematic review.</a> Pain Physician. 12 (2), 379-397 (2009).</li></ol>

Nyere studier har vist at SCS kan pålitelig forbedre ulike smerte komponentene i FBSS pasienter, forbedre livskvaliteten (f.eks kvaliteten på søvn og fysisk aktivitet), og disse fordelene opprettholdes under langsiktig oppfølging 3 , 17 , 18 , 19.
Avhengig av lokalisering av smerte bruker vi en annen tilnærming. Når pasienten har bare ensidig LP, en PC...

Mislykkede ryggoperasjon syndrom (FBSS) refererer til vedvarende, kronisk smerte etter spinal kirurgi. Før FBSS kan bli etablert, andre forhold, for eksempel vedvarende nerve rot komprimering, permanent nerve rot skade som følge av den opprinnelige komprimering eller kirurgi, arachnoiditis, feil første diagnoser og dokumentert mekanisk årsaker ryggsmerter (for eksempel spinal ustabilitet, bakre felles slitasjegikt, spondylolysthesis og discogenic smerte), skal ekskluderte1,2,3. FBSS pasienter kan ha alvorlige eller deaktivere nevropatisk smerte og syndromet er bekymringsfull siden det er kronisk og motstandsdyktig mot konvensjonelle behandling. Dens forekomsten og utbredelsen er lik de av revmatoid artritt4. Det er derfor en stor byrde for industrialiserte samfunn5.
Ryggmargen stimulering (SCS) med dorsal epidural leder kan brukes til å behandle ryggsmerter (BP) og etappe smerte (LP) på FBSS pasienter, men SCS smerte lindring mekanismen ikke har blitt fullstendig undersøkt. Ifølge gate-kontroll teori, som ble først foreslått av Ronald Melzack og Patrick Wall i 1965, hjernen overvåker aktiviteten til et lite nettverk fordelt langs dorsal horn i ryggmargen som reguleres av nociceptive men også ikke-nociceptive afferente6. Disse komplekse kretser i overfladisk dorsal horn i ryggmargen er ansvarlig for å lindre smerter på et bestemt sted i kroppen når en intens taktile stimulans brukes til samme sted7,8. Imidlertid har flere studier vist at SCS ikke er bare avhengig av denne teorien. Flere nevrotransmittere (acetylkolin, gamma - aminobutyric acid og serotonin) er rapportert å ha en rolle i den SCS mekanisme9,10,11,12, samt tallrike hjernen områder 13 , 14 og ulike spinal fiber15.
En SCS enhet inneholder en epidural ledelsen og interne puls generator (IPG) en skjøteledning koble kundeemnet til IPG. Stimulering justeres av en ekstern fjernkontroll. To typer elektrode kan brukes, nemlig PCI og kirurgisk fører.
Effekten av SCS i å forbedre radicular LP komponenten av FBSS har allerede vist i tidligere publiserte studier, inkludert bevis studie16, og to nye teknologier har nylig vist seg å være effektive for behandling av BP komponenten, som er kjent for å være gjenstridig å SCS. Den første er høyfrekvente stimulering17. Den andre er bruk av kirurgiske med flere kolonner bly3,18. De viktigste ulempene med tidligere teknikken er at deres batterier trenger hyppigere lading og at programmering optimalisering er utfordret av lenger "vaske-in" ganger19. Sistnevnte teknikken er mer invasiv enn PCI høyfrekvente stimulering teknikken fordi den krever en liten laminectomy, gjør peroperative parestesier kartlegging under lokalbedøvelse utfordrende, men mulig3. Denne fremgangsmåten kan faktisk utføres under lokalbedøvelse supplert med bevisst sedasjon eller spinal anestesi3. I sykehuset vårt, når målretting ryggsmerter i FBSS pasienter, legger vi slike inngrep fører gjennom en liten laminectomy på 10th thorax nivå med pasienten under narkose. Varig effekten av denne metoden med slike med flere kolonner leder for behandling av LP og BP i FBSS pasienter har blitt demonstrert av 3 års oppfølging18. Detaljert protokollen vår metode er angitt nedenfor.

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	<tbody>
		<tr>
			<td>16-20 GA needle</td>
			<td>BD Insyte- W</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>NaCl 0.9% 1 L</td>
			<td>Baxter</td>
			<td>AKE1324</td>
			<td></td>
		</tr>
		<tr>
			<td>Iso-betadine Dermic (500mL)</td>
			<td>MEDA</td>
			<td>09461.16</td>
			<td></td>
		</tr>
		<tr>
			<td>Iso-betadine Soap (500mL)</td>
			<td>MEDA</td>
			<td>09462.10</td>
			<td></td>
		</tr>
		<tr>
			<td>Iso-betadine hydroalcoolic (125 mL)</td>
			<td>MEDA</td>
			<td>41534.1</td>
			<td></td>
		</tr>
		<tr>
			<td>Ziehm Vision R FD</td>
			<td>Ziehm Imaging Inc.</td>
			<td>CB05183</td>
			<td></td>
		</tr>
		<tr>
			<td>Marcain 0.5% + adrenaline 1/200.000 20 mL</td>
			<td>Astrazenca</td>
			<td>PA 970/46/2</td>
			<td>0.5% Bupivacaine/1:200,000 adrenaline solution&#160;</td>
		</tr>
		<tr>
			<td>external Neurostimulator (eNs)&#160;</td>
			<td>&#160;Medtronic Inc., MN, USA</td>
			<td>37022</td>
			<td></td>
		</tr>
		<tr>
			<td>Trousse de colonne lombaire CHR Citadelle (Procedure pack)&#160;</td>
			<td>M&#246;lnlycke</td>
			<td>97061425-01</td>
			<td></td>
		</tr>
		<tr>
			<td>OR Table</td>
			<td>Maquet</td>
			<td>1150.30D0</td>
			<td></td>
		</tr>
		<tr>
			<td>OR Lights</td>
			<td>Trumpf</td>
			<td>1929278</td>
			<td></td>
		</tr>
		<tr>
			<td>Specify SureScan MRI</td>
			<td>&#160;Medtronic Inc., MN, USA</td>
			<td>977C165</td>
			<td>Multicolumn lead</td>
		</tr>
		<tr>
			<td>Primeadvanced surescan mri neurostimulator&#160;</td>
			<td>&#160;Medtronic Inc., MN, USA</td>
			<td>97702</td>
			<td>Internal Pulse Generator</td>
		</tr>
		<tr>
			<td>Monocryl 3/0</td>
			<td>Ethicon</td>
			<td>Y423</td>
			<td></td>
		</tr>
		<tr>
			<td>Polysorb 2/0</td>
			<td>Covidien</td>
			<td>GL123</td>
			<td></td>
		</tr>
		<tr>
			<td>Polysorb 1</td>
			<td>Covidien</td>
			<td>CL535</td>
			<td></td>
		</tr>
		<tr>
			<td>Polysorb 2</td>
			<td>Covidien</td>
			<td>CL055</td>
			<td></td>
		</tr>
		<tr>
			<td>Cutiplast Steril 20x10 cm</td>
			<td>Smith&#38;Nephew</td>
			<td>66001475</td>
			<td>Bandage</td>
		</tr>
		<tr>
			<td>MyStim Programmer</td>
			<td>&#160;Medtronic Inc., MN, USA</td>
			<td>97740</td>
			<td></td>
		</tr>
		<tr>
			<td>FixoCath</td>
			<td>Pajunk</td>
			<td>001151-37Z</td>
			<td></td>
		</tr>
		<tr>
			<td>N&#39;Vision Programmer&#160;</td>
			<td>&#160;Medtronic Inc., MN, USA</td>
			<td>8840</td>
			<td></td>
		</tr>
		<tr>
			<td>3M Tegaderm Film 10x12cm</td>
			<td>3M Deutschland GmbH</td>
			<td>1626W</td>
			<td></td>
		</tr>
		<tr>
			<td>Extension Kit</td>
			<td>Medtronic Inc., MN, USA</td>
			<td>37081-40</td>
			<td></td>
		</tr>
		<tr>
			<td>Paracetamol</td>
			<td>Fresenius Kabi</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tradonal&#160;</td>
			<td>Meda Pharma</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sufentanil</td>
			<td>Janssen- Cilag</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Propolipid 1%</td>
			<td>Fresenius Kabi</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Ketalar (Ketamine Hydrochloride)</td>
			<td>Pfizer</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Rocuronium Bromide</td>
			<td>Bbraun</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Cefazolin</td>
			<td>Milan</td>
			<td></td>
			<td></td>
		</tr>
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treating low back pain in failed back surgery patients with multicolumn-lead spinal cord stimulation

Mislykkede ryggoperasjon syndrom (FBSS) refererer til vedvarende, kronisk smerte etter spinal kirurgi. Ryggmargen stimulering med dorsal epidural leder kan brukes til å behandle rygg og bein smerte i FBSS pasienter. Dette dokumentet presenterer en detaljert protokoll for bruke ryggmargen stimulering med kirurgisk leder i FBSS pasienter. I vår avdeling, med pasienten under narkose, plasserer vi ledelsen i epidural plass med en liten laminectomy på 10th thorax nivå. Plassering av ledelsen er etterfulgt av en 1 måned prøveperiode med en externalized bly. Hvis smertelindring er større enn 50% på slutten av 1 måned stimulering (kreves av belgiske refusjon kriterier), en intern puls generator deretter plassert under huden og koblet til ledelsen i en andre inngrep fremgangsmåte. Vi har vist at bruker denne teknikken i omhyggelig utvalgte FBSS pasienter kan forbedre ryggsmerter, smerter, pasientjournal aktivitet og livskvalitet for en vedvarende periode.

En prospektiv, ikke-randomiserte, kontrollert studie av 62 påfølgende FBSS pasienter som ble implantert med en med flere kolonner innlede benytter denne metoden i vårt senter, CHR Citadelle, i Liège, Belgia, ble nylig publisert i Neuromodulation18 . Alle pasienter hadde tidligere spinal kirurgi, hadde blitt vist for sekundære årsaker av smertene og var ildfaste til optimal medisinsk behandling. Med flere kolonner kirurgisk fører ble plassert i 62 pasientene ...

Watch this Scientific Journal Video about Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation at JoVE.com

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation

Behandling av korsryggsmerter i mislykkede tilbake kirurgi pasienter med fleirkolonnar-bly ryggmargen stimulering

Dette dokumentet presenterer en metode som bruker ryggmargen stimulering med en med flere kolonner føre til å behandle neuropathic ryggsmerter i mislykkede tilbake kirurgiske pasienter.

Failed back surgery syndrome (FBSS) refers to persistent, chronic pain following spinal surgery. Spinal cord stimulation with dorsal epidural leads can be ...

Research

JoVE Journal

Behavior

Functional Magnetic Resonance Imaging (fMRI) with Auditory Stimulation in Songbirds

Functional Magnetic Resonance Imaging fMRI with Auditory Stimulation in Songbirds

Funksjonell Magnetic Resonance Imaging (fMRI) med auditiv stimulering i Songbirds

The neurobiology of birdsong, as a model for human speech, is a pronounced area of research in behavioral neuroscience. Whereas electrophysiology and ...

Use of the Operant Orofacial Pain Assessment Device (OPAD) to Measure Changes in Nociceptive Behavior

Use of the Operant Orofacial Pain Assessment Device OPAD to Measure Changes in Nociceptive Behavior

Bruk av Operant Orofacial Pain Assessment Device (OPAD) for å måle endringer i Nociceptive Behavior

We present an operant  system for the detection of pain in awake, conscious rodents. The Orofacial  Pain Assessment Device (OPAD) assesses pain behaviors ...

Stimulating the Lip Motor Cortex with Transcranial Magnetic Stimulation

Stimulere Lip Motor Cortex med transkranial magnetisk stimulering

Transcranial magnetic stimulation (TMS) has proven to be a useful tool in investigating the role of the articulatory motor cortex in speech perception. ...

Treating Clinical Depression with Repetitive Deep Transcranial Magnetic Stimulation Using the Brainsway H1-coil

Behandling av klinisk depresjon med Repetitive Deep Transkranial magnetisk stimulering Bruke Brainsway H1-spiral

Repetitive transcranial magnetic stimulation (rTMS) is an emerging non-pharmacological approach to treating many brain-based disorders. rTMS uses ...

Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

Eye-Tracking Control for å vurdere kognitive funksjoner hos pasienter med amyotrofisk lateral sklerose

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to ...

Using Laser Doppler Imaging and Monitoring to Analyze Spinal Cord Microcirculation in Rat

Bruker Laser Doppler avbildning og overvåking for å analysere ryggmargen mikrosirkulasjonen i rotte

Laser Doppler flowmetry (LDF) is a noninvasive method for blood flow (BF) measurement, which makes it preferable for measuring microcirculatory ...

Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury

Paradigmene for nedre ekstremitet elektrisk stimulering trening etter ryggmargsskade

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with ...

Brain State-dependent Brain Stimulation with Real-time Electroencephalography-Triggered Transcranial Magnetic Stimulation

Brain State-avhengig Brain stimulering med Real-Time Elektroencefalogram-utløst Transkraniell magnetisk stimulering

The effect of a stimulus to the brain depends not only on the parameters of the stimulus but also on the dynamics of brain activity at the time of the ...

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

Home-based foreskrevet lunge øvelse hos pasienter med stabil kronisk obstruktiv lungesykdom

As a systemic disease, chronic obstructive pulmonary disease (COPD) affects the respiratory system, inducing restless and exercise dyspnea. It also ...

Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction

Bruke enveis rotasjoner for å forbedre Vestibular system asymmetri hos pasienter med Vestibular dysfunksjon

The vestibular system provides information about head movement and mediates reflexes that contribute to balance control and gaze stabilization during ...