A5041273664- Pain Management and Treatment
- Musculoskeletal pain and rehabilitation
- Pain Mechanisms and Treatments
- Spine and Intervertebral Disc Pathology
- Transcranial Magnetic Stimulation Studies
- Anesthesia and Pain Management
- Myofascial pain diagnosis and treatment
- Nerve Injury and Rehabilitation
- Botulinum Toxin and Related Neurological Disorders
- Shoulder Injury and Treatment
- Pregnancy-related medical research
- Health Systems, Economic Evaluations, Quality of Life
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Central Venous Catheters and Hemodialysis
- Hemodynamic Monitoring and Therapy
- Neurological disorders and treatments
- Migraine and Headache Studies
- Vagus Nerve Stimulation Research
- Blood Coagulation and Thrombosis Mechanisms
- Spinal Fractures and Fixation Techniques
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Venous Thromboembolism Diagnosis and Management
- Vascular Procedures and Complications
Carolinas Pain Institute
2016-2025
Center for Clinical Research (United States)
2016-2025
Nottingham University Hospitals NHS Trust
2020
Queen's Medical Centre
2020
Wake Forest University
2017-2018
Atrium Health Wake Forest Baptist
2016-2017
Prince Charles Hospital
2015
Background and objectives Chronic neuropathic pain is a common challenging condition following amputation. Recent research demonstrated the feasibility of percutaneously implanting fine-wire coiled peripheral nerve stimulation (PNS) leads in proximity to sciatic femoral nerves for postamputation pain. A multicenter, double-blinded, randomized, placebo-controlled study collected data on safety effectiveness percutaneous PNS chronic Methods Twenty-eight lower extremity amputees with were...
Peripheral nerve stimulation has been used for decades to treat chronic pain but not postoperative analgesia due multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gauge leads enabling percutaneous insertion, ultrasound guidance accurate introduction, and stimulators small enough be adhered skin, neurostimulation may now provided in a similar manner continuous peripheral blocks. Here, we report on use ultrasound-guided pain. Subjects...
Peripheral nerve stimulation (PNS) has historically been used to treat chronic pain, but generally requires implantation of a permanent system for sustained relief. A recent study found that 60-day PNS treatment decreases post-amputation and the current work investigates longer-term outcomes out 12 months in same cohort.
<h3>Importance</h3> Chronic pain is debilitating and profoundly affects health-related quality of life. Spinal cord stimulation (SCS) a well-established therapy for chronic pain; however, SCS has been limited by the inability to directly measure elicited neural response, precluding confirmation activation continuous therapy. A novel system measures evoked compound action potentials (ECAPs) produce real-time physiological closed-loop control system. <h3>Objective</h3> To determine whether...
Introduction The evidence for spinal cord stimulation (SCS) has been criticized the absence of blinded, parallel randomized controlled trials (RCTs) and limited evaluations long-term effects SCS in RCTs. aim this study was to determine whether evoked compound action potential (ECAP)-controlled, closed-loop (CL-SCS) is associated with better outcomes when compared fixed-output, open-loop (OL-SCS) 36 months following implant. Methods EVOKE a multicenter, participant-blinded,...
BackgroundAdults with refractory, mechanical chronic low back pain associated impaired neuromuscular control of the lumbar multifidus muscle have few treatment options that provide long-term clinical benefit. This study hypothesized restorative neurostimulation, a rehabilitative activates muscles to overcome underlying dysfunction, is safe and provides relevant durable benefit patients this specific etiology.Materials MethodsIn prospective five-year longitudinal follow-up ReActiv8-B pivotal...
The aim was to compare the efficacy of intradiscal biacuplasty (IDB) with that placebo treatment for discogenic low back pain. This is a randomized, placebo-controlled trial. Subjects were randomized on 1:1 basis IDB and sham groups. Follow-ups conducted at 1, 3, 6 months. coordinators blinded randomization until Of 1,894 subjects screened, 64 enrolled, 59 treated: 29 30 sham. All had history chronic pain longer than Two cooled radiofrequency (RF) electrodes placed in bipolar manner affected...
While neurostimulation-stimulation of the nervous system using electrical current-has been used to treat chronic pain, its use treating postsurgical pain has limited. Here, we report on clinical application a novel investigational lead provide analgesia following total knee arthroplasty. In 5 subjects, leads were inserted percutaneously ultrasound guidance within 0.5 3.0 cm femoral and/or sciatic nerve(s). With delivery current, decreased an average 63% at rest, with 4 subjects having relief...
Percutaneous peripheral nerve stimulation (PNS) provides an opportunity to relieve chronic low back pain and reduce opioid analgesic consumption as alternative radiofrequency ablation permanently implanted neurostimulation systems. Traditionally, the use of earlier in treatment continuum has been limited by its associated risk, invasiveness, cost.
Chronic abdominal pain (CAP) can arise from multiple conditions, including inflammatory disorders, trauma because of injury or surgery, structural functional causes. This prospective, single-arm study was designed to evaluate the safety and efficacy 10-kHz spinal cord stimulation (SCS) in patients with intractable CAP over a 12-month follow-up period.Subjects who had been refractory conventional medical treatment for at least 3 months resulting self-reported scores ≥5 cm on 10-cm visual...
Abstract Chronic low back pain can be caused by impaired control and degeneration of the multifidus muscles consequent functional instability lumbar spine. Available treatment options have limited effectiveness prognosis is unfavorable. We conducted an international randomized, double-blind, sham-controlled trial at 26 multidisciplinary centers to determine safety efficacy implantable, restorative neurostimulator designed restore neuromuscular facilitate relief symptoms (clinicaltrials.gov...
Impaired neuromuscular control and degeneration of the multifidus muscle have been linked to development refractory chronic low back pain (CLBP). An implantable restorative-neurostimulator system can override underlying inhibition by eliciting episodic, isolated contractions. The ReActiv8-B randomized, active-sham-controlled trial provided effectiveness safety evidence for this system, all participants received therapeutic stimulation from four months onward. This study aimed evaluate...
Restorative neurostimulation is a rehabilitative treatment for patients with refractory chronic low back pain (CLBP) associated dysfunction of the lumbar multifidus muscle resulting in impaired neuromuscular control. The ReActiv8-B randomized, sham-controlled trial provided evidence effectiveness and safety an implanted, restorative neurostimulator. two-year analysis previously published this journal demonstrated accrual clinical benefits long-term durability. Evaluation three-year...
Abstract Introduction Chronic pain and reduced function are significant problems for Military Service members Veterans following amputation. Peripheral nerve stimulation (PNS) is a promising therapy, but PNS systems have traditionally been limited by invasiveness complications. Recently, novel percutaneous system was developed to reduce the risk of complications enable delivery without surgery. Materials Methods Percutaneous evaluated determine if provides relief from residual phantom limb...
Spinal cord stimulation (SCS) has been challenged by the lack of neurophysiologic data to guide therapy optimization. Current SCS programming trial-and-error results in suboptimal and variable therapeutic effects. A novel system with a physiologic closed-loop feedback mechanism using evoked-compound action potentials enables optimization neural dose consistently accurately activating spinal fibers. We aimed identify metrics their ranges that resulted clinically meaningful treatment responses.
Abstract Many amputees suffer from postamputation pain, which can be extremely debilitating, decrease quality of life, increase the risk depression, and negatively affect interpersonal relationships ability to work. Present methods treatment, including medications, are often unsatisfactory in reducing pain. Electrical stimulation nerve innervating painful area could reduce but peripheral is rarely used treat pain because present require invasive surgical access precise placement leads close...
Lumbar radiofrequency ablation is a commonly used intervention for chronic back pain. However, the pain typically returns, and though retreatment may be successful, procedure involves destruction of medial branch nerves, which denervates multifidus. Repeated procedures have diminishing can lead to opioid use, surgery, or implantation permanent neuromodulation systems. The objective this report demonstrate potential use percutaneous peripheral nerve stimulation (PNS) as minimally invasive,...
The objective of this prospective, multicenter study is to characterize responses percutaneous medial branch peripheral nerve stimulation (PNS) determine if results from earlier, smaller single-center studies and reports were generalizable when performed at a larger number wider variety centers in patients recalcitrant nonsurgical treatments.Participants with chronic axial low back pain (LBP) implanted PNS leads targeting the lumbar nerves for up 60 days, after which removed. Participants...
Introduction A novel, spinal cord stimulation (SCS) system with a physiologic closed-loop (CL) feedback mechanism controlled by evoked compound action potentials (ECAPs) enables the optimization of neural dose and accuracy stimulation, not possible any other commercially available SCS systems. The report objective measurements is essential to increase transparency reproducibility therapy. Here, we cohort EVOKE double-blind randomized trial treated CL-SCS for 36 months evaluate ECAP that...