Synopsis
Post dural puncture headaches are, more recently, being documented as a complication related to spinal cord stimulator placement. Dural compromise are usually appreciated prior to this condition's onset. A viable treatment for post dural headaches is epidural blood patches. Less reported in literature still, is the presence of post dural headache after leads removal from a trail spinal cord stimulator, when initial placement of the spinal cord stimulator was without noted dural compromise and tolerated by the patient well prior to its removal.
Disclosures
Nothing to Disclose by any Author
Speaker(s):Synopsis
In order to overcome barriers to adoption of neurostimulation technologies by patients and clinicians, we present here a minimally invasive needle placeable and fully implanted neurostimulator that is suitable for clinical imaging (U/S, X-Ray, MRI). The structural design and placement procedure of the injectable helical wire structure electrode (Injectrode) renders the device self anchoring and deliverable using a minimal number of components. Demonstrated are placements by clinicians on various nerve targets in animal and human models.
Disclosures
Synopsis
Here we propose a characterization of Fibromyalgia pathophysiology in gray matter (GM) tissue using a multimodal neuroimaging approach (volumetric, diffusion-weighted, and resting-state functional connectivity).
Disclosures
Nothing to Disclose by any Author
Speaker(s):Synopsis
Evoked compound action potentials (ECAPs) from both the dorsal columns and the anterolateral system (ALS) in sheep were used to quantify neural activation with burst and conventional spinal cord stimulation (SCS). When dosed equivalently, no statistically significant difference in neural activation was noted between both stimulation modalities. Sub-threshold SCS resulted in no change in neural activation, while supra-threshold SCS potentiated ALS excitability in an equivalent manner for both modalities. We postulate that differences noted previously between burst and conventional SCS results from non-equivalent dosing between these stimulation modalities.
Disclosures
Synopsis
Medical practices and hospitals have adopted Electronic Health Record (EHR) systems that streamline patient information and relevant clinical data. Access to an EHR system with effective exchange of electronic health information is critical in maintaining data consistency and reliability. Human errors that occur during the transcription of data from one field to another, or from a paper to an electronic record, can negatively impact patient care and reduce efficiency. Human transcription errors can occur as early as the scheduling process, with these errors compounding as more individuals touch and re-transcribe the data. Though previous literature have touched upon error rates, they have not addressed the complexity of patient data involved with scheduling.
Disclosures
Nothing to Disclose by any Author
Speaker(s):Synopsis
The incidence of Post Dural Puncture Headaches (PDPH) is less than 1% with the use of fluoroscopy. PDPH typically occurs due to accidental dural puncture during initial epidural needle placement. We present a case of a 44 year-old male with history of aplastic anemia who presented with bilateral hand and lower extremity paresthesia with severe allodynia refractory to treatment. The patient experienced significant relief of symptoms after dual thoracic and single cervical SCS lead placement He presented with slow-onset headache after three days from cervical lead tip puncture. To date, there is a paucity of papers describing such an occurrence.
Disclosures
Nothing to disclose by any author
Speaker(s):Synopsis
Spinal cord stimulation (SCS) is primarily used to treat persistent back and leg pain following spine surgery, but minimal evidence existed to show efficacy in patients who were surgery naïve. This randomized controlled trial was designed to demonstrate the clinical efficacy of 10kHz SCS in chronic back pain patients who were surgery naïve and not acceptable candidates for surgery. Recently published 12-month results showed profound improvements in pain relief, function, and quality of life with 10kHz SCS over conventional medical management for non-surgical refractory back pain (NSRBP) patients. We now report 18-month results demonstrating the durability of these therapeutic outcomes.
Disclosures