Electromedicine

Saha, Subrata; Kashi, Ajay

doi:10.1201/b14253-82

Cited by 34 publications

(52 citation statements)

References 1 publication

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“…Application of SCS at T1-T2 or higher spinal segments provides promising benefits in patients with angina pectoris. These benefits includes pain relief, reduction in both frequency and to some extent severity of angina attacks, and a reduced shortacting nitrate intake (Jessurun et al, 1996;Stojanovic and Abdi, 2002;Yu, et al, 2004;Chua and Keogh, 2005;Buchser et al, 2006;). Thus, SCS improves the quality of life in patients with angina pectoris by alleviating the symptoms (Yu, et al, 2004).…”

Section: 15mentioning

confidence: 99%

Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: A review of experimental studies

Linderoth

Foreman

2008

Autonomic Neuroscience

159

106

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Spinal cord stimulation (SCS) is a widely used clinical technique to treat ischemic pain in peripheral, cardiac and cerebral vascular diseases. The use of this treatment advanced rapidly during the late 80's and 90's, particularly in Europe. Although the clinical benefits of SCS are clear and the success rate remains high, the mechanisms are not yet completely understood. SCS at lumbar spinal segments (L2-L3) produces vasodilation in the lower limbs and feet which is mediated by antidromic activation of sensory fibers and decreased sympathetic outflow. SCS at thoracic spinal segments (T1-T2) induces several benefits including pain relief, reduction in both frequency and severity of angina attacks, and reduced short-acting nitrate intake. The benefits to the heart are not likely due to an increase, or redistribution of local blood flow, rather, they are associated with SCS-induced myocardial protection and normalization of the intrinsic cardiac nervous system. At somewhat lower cervical levels (C3-C6), SCS induces increased blood flow in the upper extremities. SCS at the upper cervical spinal segments (C1-C2) increased cerebral blood flow, which is associated with a decrease in sympathetic activity, an increase in vasomotor center activity and a release of neurohumoral factors. This review will summarize the basic science studies that have contributed to our understanding about mechanisms through which SCS produces beneficial effects when used in the treatment of vascular diseases. Furthermore, this review will particularly focus on the antidromic mechanisms of SCS-induced vasodilation in the lower limbs and feet.

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Section: 15mentioning

confidence: 99%

Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: A review of experimental studies

Linderoth

Foreman

2008

Autonomic Neuroscience

159

106

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“…9 To treat lower-extremity pain in patients with CLI, 4 to 8 electrodes are generally placed in the epidural space between the thoracic 8 and 11 level through a paralaminar level 1 or 2 lumbar puncture. 4,10 The electrodes are usually centered in the spinal canal or directed off-center, depending on the location of the limb with the most significant symptoms. 18 In general, patients may often undergo a trial use of SCS to determine the optimal location of lead placement and to ascertain if the procedure provides pain relief as expected.…”

mentioning

confidence: 99%

Spinal Cord Stimulation for Chronic Limb Ischemia

Naoum

Arbid

2013

Methodist DeBakey Cardiovascular Journal

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The treatment of chronic limb ischemia involves the restoration of pulsatile blood flow to the distal extremity. Some patients cannot be treated with endovascular means or with open surgery; some may have medical comorbidities that render them unfit for surgery, while others may have persistent ischemia or pain even in the face of previous attempts at reperfusion. In spinal cord stimulation (SCS), a device with electrodes is implanted in the epidural space to stimulate sensory fibers. This activates cell-signaling molecules that in turn cause the release of vasodilatory molecules, a decrease in vascular resistance, and relaxation of smooth muscle cells. SCS also suppresses sympathetic vasoconstriction and pain transmission. When patient selection is based on microcirculatory parameters, SCS therapy can significantly improve pain relief, halt the progression of ulcers, and potentially achieve limb salvage.

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“…Spinal kord stimülasyonu (SKS), başa-rısız bel cerrahisi sendromu, nöropatik ağrı, kompleks rejyonal ağrı sendromu, periferik vasküler hastalık, iskemik kalp hastalığı gibi birçok kronik ağrılı durumda uygulanan bir nöromodülasyon yöntemidir. [2][3][4][5] Subkutanöz stimülasyon (SUBQ) ya da periferal sinir sahasının stimülasyonunun (PSSS) kronik ağrı sendromlarının tedavisinde terapötik yöntemlerde bir potansiyele sahip olduğu görünmektedir. Spinal kord stimülasyonunun aksine SUBQ stimülasyonu etkilenen ağrı bölgesindeki kutanöz afferent ya da bu sinirlerin dermatomal dağılımlarının olduğu Alana yerleştirerek sağlanır.…”

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