Post Dural Puncture Headache After Removal of Spinal Cord Stimulator Leads: A Case Report

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

A self-anchoring injectable helical wire rope structure electrode (Injectrode) enables ease of placement and clear imaging

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

• Stephan Nieuwoudt is employed by and owns equity in Neuronoff, Inc. 
• Amelia Howe is employed by and owns equity in Neuronoff, Inc. 
• Johanna Pearson is employed by Neuronoff, Inc. 
• Emily Szabo is employed by and owns equity in Neuronoff, Inc. 
• Morgan McGaughey is employed by and owns equity in Neuronoff, Inc. 
• Derrick Liu is employed by and owns equity in Neuronoff, Inc. 
• Shaher Ahmad is employed by and owns equity in Neuronoff, Inc. 
• Kip A. Ludwig is receiving funds from and owns equity in Neuronoff, Inc.
• Hesham Elsharkawy owns equity in Neuronoff, Inc. 
• Amol Soin owns equity in Neuronoff, Inc. 
• Alaa Abd-Elsayed owns equity in Neuronoff, Inc. 
• Manfred Franke is employed by and owns equity in Neuronoff, Inc. 
• Andrew J. Shoffstall is receiving funds from and owns equity in Neuronoff, Inc.
• This project is supported by Neuronoff Inc., NIH 1U18EB029251-01 Grant, and the DARPA EEI program. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense or the National Institutes of Health.

Multimodal Imaging Analysis of Fibromyalgia Syndrome Reveals Structural and Functional Abnormalities in Cortico-Thalamic Loops

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

Mechanistic Insights into Anterolateral System Modulation with Conventional and Burst Stimulation

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

• Authors Dinsmoor and Usoro are employees of Medtronic plc. 
• Author Poree has stock options in Nalu, and has received research funding from Abbott, Nalu, and Saluda; he is a consultant for Nalu, Saluda, and Medtronic. 
• This work was funded by Medtronic plc.

Human Transcription Error Assessment within a Simulated Electronic Health Record System

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

Atypical Presentation of Post-Dural Puncture Headache from Cervical Spinal Cord Stimulator Lead Placement

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

18 Month Outcomes from Multicenter RCT: Spinal Cord Stimulation at 10kHz for Non-Surgical Refractory Back Pain

Aug 21, 2022 3:00pm ‐ Aug 21, 2022 3:00pm

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

• Taissa Cherry, MD has contracted research with Nevro Corp, with all funds going to her institution
• Jessica Jameson, MD receives consulting and speaking fees from Nevro, Boston Scientific
• Naresh P. Patel, MD has contracted research with Nevro Corp, with all funds going to his institution
  
• Curtis Johnson, MD has contracted research with Nevro Corp
• Daniel Kloster, MD has contracted research with Nevro Corp
• Aaron K. Calodney, MD AC receives consulting fees from Nevro Corp.
• Rose Province-Azalde, MS Employee of Nevro Corp.
• Leonardo Kapural, MD, PhD on scientific advisory board for Abbott, Nevro, Saluda, SPR therapeutics, Neuros, Halyard. Is a consultant: Gimer Medical, Best Doctors, Solis Medical, Nalu Medical, Biotronik, Nevro, and has research contracts with Stimwave, Nevro, Neuros, Halyard, SPR therapeutics, Boston Scientific, Medtronic, Saluda.