Technical Aspects of Spinal Cord Stimulation for Managing Chronic Visceral Abdominal Pain: The Results from the National Survey

Kapural, Leonardo; Deer, Timothy R.; Yakovlev, Alexander E.; Bensitel, Toula; Hayek, Salim M.; Pyles, Stephen; Khan, Yasin N.; Kapural, Alberta; Cooper, Dondre; Stearns, Lisa; Zovkic, Paulina

doi:10.1111/j.1526-4637.2010.00806.x

Cited by 58 publications

(24 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another point is that selective visceral blocks and procedures (celiac, hypogastric, and splanchnic blocks, spinal cord stimulators, radiofrequency ablation, and midline myelotomy) needed to complement medical management [35, 227–229]. Multimodality approach for pain management requires a multidisciplinary group of experts.…”

Section: Pharmacologic Management Of Visceral Painmentioning

confidence: 99%

Drug Management of Visceral Pain: Concepts from Basic Research

Davis

2012

Pain Research and Treatment

View full text Add to dashboard Cite

Visceral pain is experienced by 40% of the population, and 28% of cancer patients suffer from pain arising from intra- abdominal metastasis or from treatment. Neuroanatomy of visceral nociception and neurotransmitters, receptors, and ion channels that modulate visceral pain are qualitatively or quantitatively different from those that modulate somatic and neuropathic pain. Visceral pain should be recognized as distinct pain phenotype. TRPV1, Na 1.8, and ASIC3 ion channels and peripheral kappa opioid receptors are important mediators of visceral pain. Mu agonists, gabapentinoids, and GABAB agonists reduce pain by binding to central receptors and channels. Combinations of analgesics and adjuvants in animal models have supra-additive antinociception and should be considered in clinical trials. This paper will discuss the neuroanatomy, receptors, ion channels, and neurotransmitters important to visceral pain and provide a basic science rationale for analgesic trials and management.

show abstract

Section: Pharmacologic Management Of Visceral Painmentioning

confidence: 99%

Drug Management of Visceral Pain: Concepts from Basic Research

Davis

2012

Pain Research and Treatment

View full text Add to dashboard Cite

show abstract

“…Spinal cord stimulation has been used to treat abdominal pain in several conditions, such as, mesenteric ischemia, chronic pancreatitis, diffuse abdominal adhesions, and chronic pelvic pain after endometriosis. [5355565763153] Kapural et al . has found that SCS seems to produce long-term pain relief and a decrease in opioid use in these patients.…”

Section: Indications and Resultsmentioning

confidence: 99%

“…has found that SCS seems to produce long-term pain relief and a decrease in opioid use in these patients. [53] Yakovlev and Resch have reported a case in which SCS has produced excellent relief of urinary incontinence symptoms in a patient with both urinary incontinence and low back pain related to FBSS. In this patient, SCS has been effective in controlling the urinary voiding dysfunction symptoms, but the use of SCS to treat these urinary voiding problems needs further investigation.…”

Section: Indications and Resultsmentioning

confidence: 99%

Dorsal column stimulator applications

Yampolsky¹,

Hem²,

Bendersky³

2012

Surg Neurol Int

View full text Add to dashboard Cite

Background:Spinal cord stimulation (SCS) has been used to treat neuropathic pain since 1967. Following that, technological progress, among other advances, helped SCS become an effective tool to reduce pain.Methods:This article is a non-systematic review of the mechanism of action, indications, results, programming parameters, complications, and cost-effectiveness of SCS.Results:In spite of the existence of several studies that try to prove the mechanism of action of SCS, it still remains unknown. The mechanism of action of SCS would be based on the antidromic activation of the dorsal column fibers, which activate the inhibitory interneurons within the dorsal horn. At present, the indications of SCS are being revised constantly, while new applications are being proposed and researched worldwide. Failed back surgery syndrome (FBSS) is the most common indication for SCS, whereas, the complex regional pain syndrome (CRPS) is the second one. Also, this technique is useful in patients with refractory angina and critical limb ischemia, in whom surgical or endovascular treatment cannot be performed. Further indications may be phantom limb pain, chronic intractable pain located in the head, face, neck, or upper extremities, spinal lumbar stenosis in patients who are not surgical candidates, and others.Conclusion:Spinal cord stimulation is a useful tool for neuromodulation, if an accurate patient selection is carried out prior, which should include a trial period. Undoubtedly, this proper selection and a better knowledge of its underlying mechanisms of action, will allow this cutting edge technique to be more acceptable among pain physicians.

show abstract

“…The most frequent placement of the electrical lead was in the posterior epidural space, midline, and with the tip of the lead at the height T5 vertebral body. They were 23 patients with confirmed diagnosis of chronic pancreatitis in this study [33].…”

Section: Anatomic Considerationsmentioning

confidence: 99%

“…The second study was a national survey investigating technical aspects on SCS for chronic abdominal pain, which included 70 patients [33]. The most frequent placement of the electrical lead was in the posterior epidural space, midline, and with the tip of the lead at the height T5 vertebral body.…”

Section: Anatomic Considerationsmentioning

confidence: 99%

Interventional Pain Management Approaches for Control of Chronic Pancreatic Pain

Kapural

Jolly

2016

Curr Treat Options Gastro

Self Cite

View full text Add to dashboard Cite

Treatment of persistent pain from chronic pancreatitis historically was difficult to treat. For years, focus was on opioid and other analgesics and psychological treatments. Recent studies provided evidence for decrease in analgesic intake and pain scores after properly conducted sympathetic blocks (celiac, splanchnic nerve blocks). These therapies should be considered as parts of a multimodal analgesic strategy. Animal studies suggest that spinal cord stimulation suppresses visceral hyperalgesia. Large case series of spinal cord stimulation demonstrated a significant pain relief in patients with chronic pancreatitis. Given the limitations of conservative and surgical treatments for chronic visceral pain, spinal cord stimulation may be a very useful therapeutic option.

show abstract

Technical Aspects of Spinal Cord Stimulation for Managing Chronic Visceral Abdominal Pain: The Results from the National Survey

Abstract: In conclusion, it seems that the SCS for the treatment of the abdominal visceral pain may provide a positive patient long-term experience, significant improvements in pain scores and a decrease in opioid use.

Cited by 58 publications

References 16 publications

Drug Management of Visceral Pain: Concepts from Basic Research

Drug Management of Visceral Pain: Concepts from Basic Research

Dorsal column stimulator applications

Interventional Pain Management Approaches for Control of Chronic Pancreatic Pain

Contact Info

Product

Resources

About