A Definition of Neuromodulation and Classification of Implantable Electrical Modulation for Chronic Pain

Sivanesan, Eellan; North, Richard B.; Russo, Marc A.; Levy, Robert M.; Linderoth, Bengt; Hayek, Salim M.; Eldabe, Sam; Lempka, Scott F.

doi:10.1016/j.neurom.2023.10.004

Neuromodulation: Technology at the Neural Interface

2024

DOI: 10.1016/j.neurom.2023.10.004

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A Definition of Neuromodulation and Classification of Implantable Electrical Modulation for Chronic Pain

Eellan Sivanesan,

Richard B. North,

Marc A. Russo

et al.

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2024

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Cited by 5 publications

(1 citation statement)

References 111 publications

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“…I mplantable neuromodulation devices for the treatment of chronic pain are continuously evolving with a steady flow of novel devices and applications. 1 This is reflected in a recent 9-year span of data in which the number of spinal cord stimulator (SCS) trials was shown to have risen from 12,680 to 36,280, with a 12.4% annual rate of increase. 2 Pain medicine physicians will implant these devices in increasing numbers and as such, they will undoubtedly face postoperative wound complications.…”

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confidence: 99%

Basal Cell Carcinoma Formation Within A Spinal Cord Stimulator Surgical Scar: A Case Report

DeJulio,

Yih,

Dang

et al. 2024

A&A Practice

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Implanting neuromodulation devices requires that pain medicine physicians be well-versed in proper surgical technique and postoperative wound management. To be able to identify abnormal wound healing, a basic understanding of normal wound healing is required. When postoperative wounds deviate from expected healing, it is important that pain medicine physicians entertain a broad differential diagnosis, including nonsurgical dermatologic pathology.

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mentioning

confidence: 99%

Basal Cell Carcinoma Formation Within A Spinal Cord Stimulator Surgical Scar: A Case Report

DeJulio,

Yih,

Dang

et al. 2024

A&A Practice

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Analyzing Spinal Cord Stimulation With Different Electrode Configurations: A Numerical Study

Aydin,

Zengĺn

2024

Numer Methods Biomed Eng

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Spinal cord stimulation (SCS) represents a therapeutic approach for chronic pain management in patients refractory to conventional treatments. By implanting electrodes in the epidural space, SCS aims to mitigate pain transmission to the brain through electrical stimulation, often resulting in sensory perceptions such as paresthesia. This study investigates the influence of electrode configurations on electrical parameters, including current density and electric potential, within the spinal cord environment. Utilizing computational models of the spinal canal incorporating components such as epidural fat, cerebrospinal fluid (CSF), gray matter, and white matter, our analysis explores the distribution of electric potential and current density. Specifically, configurations employing four and nine electrodes are evaluated under both direct current (DC) and alternating current (AC) stimulations. For DC stimulations at currents of 1, 5, and 10 mA, our findings indicate that the four‐electrode model generated current density values in epidural fat ranging from 107.90 to 130.98 mA/cm2 and electric potential values ranging from 3.51 to 4.78 V. Similarly, the nine‐electrode model produced current density values ranging from 92.51 to 223.61 mA/cm2 and electric potential values ranging from 1.27 to 7.83 V under the same conditions. The results demonstrate a proportional relationship between applied current, current density, and electric potential. Furthermore, our investigation reveals a gradual decrease in electrical potential and current density from the epidural space to the gray matter. Discussions encompass the safety implications of these findings, examining whether the observed electrical parameters remain within tolerable limits for patient well‐being. Additionally, the study explores the effects of AC stimulation across frequencies ranging from 250 Hz to 10 kHz, revealing an inverse correlation between frequency and charge parameters. Specifically, higher frequencies corresponded to reduced charge per phase and charge density, underscoring the frequency‐dependent nature of these electrical properties.

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A Visual and Narrative Timeline Review of Spinal Cord Stimulation Technology and US Food and Drug Administration Milestones

Ho,

Poon,

North

et al. 2024

Neuromodulation: Technology at the Neural Interface

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A Definition of Neuromodulation and Classification of Implantable Electrical Modulation for Chronic Pain

Cited by 5 publications

References 111 publications

Basal Cell Carcinoma Formation Within A Spinal Cord Stimulator Surgical Scar: A Case Report

Basal Cell Carcinoma Formation Within A Spinal Cord Stimulator Surgical Scar: A Case Report

Analyzing Spinal Cord Stimulation With Different Electrode Configurations: A Numerical Study

A Visual and Narrative Timeline Review of Spinal Cord Stimulation Technology and US Food and Drug Administration Milestones

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