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Spinal cord implants

Carlos Julio Montaño, Tarcisio Passos Ribeiro de Campos
Polymethylmetacrylte (PMMA) is used in the fields of dentistry and biomedicine as a constituent of bone cements. Hydroxyapatite (HAp) is a bioceramic produced naturally in the bones. PMMA and HAp are fundamental constituents in the preparation of bone cements. Bisphosphonates have also been used as radiopharmaceutical in dental implants and nuclear medicine, or as palliative systemic treatment for pain reduction in bone metastasis. Vertebroplasty and kyphoplasty are bone cement-based techniques used in orthopedics, being minimally invasive procedures with low risks of infections, applied in osteoporosis and high-impact fractures...
January 2019: Acta Ortopedica Brasileira
Tao Wang, Li-Ni Zeng, Zhe Zhu, Yu-Hui Wang, Lu Ding, Wei-Bin Luo, Xiao-Min Zhang, Zhi-Wei He, Hong-Fu Wu
Brachial plexus avulsion often results in massive motor neuron death and severe functional deficits of target muscles. However, no satisfactory treatment is currently available. Hypoxia-inducible factor 1α is a critical molecule targeting several genes associated with ischemia-hypoxia damage and angiogenesis. In this study, a rat model of brachial plexus avulsion-reimplantation was established, in which C5-7 ventral nerve roots were avulsed and only the C6 root reimplanted. Different implants were immediately injected using a microsyringe into the avulsion-reimplantation site of the C6 root post-brachial plexus avulsion...
June 2019: Neural Regeneration Research
Piotr Kamieniak, Joanna Bielewicz, Cezary Grochowski, Jakub Litak, Agnieszka Bojarska-Junak, Beata Daniluk, Tomasz Trojanowski
Objectives: We investigated the influence of spinal cord stimulation (SCS) on IFN- γ , IL-1 β , IL-6, TNF- α , IL-10, and TGF- β serum levels in failed back surgery syndrome (FBSS) patients. The study will try to give new insights into the mechanism of SCS action and the role of IFN- γ and other cytokines in neuropathic pain (NP) development. Materials and Methods: Clinical and biochemical assessment was conducted in four groups of patients: group 0 consisted of 24 FBSS patients qualified to SCS therapy, group 1 included 17 patients who were one month after implantation, group 2 featured 12 patients who were 3 months after the implantation, and group C (the control group) with no NP...
2019: Disease Markers
Filipe O Barroso, Bryan Yoder, David Tentler, Josephine Wallner, Amina Kinkhabwala, Maria K Jantz, Robert D Flint, Pablo Tostado, Evonne Pei, Ambika Satish, Sarah Brodnick, Aaron Suminski, Justin C Williams, Lee E Miller, Matthew Tresch
OBJECTIVE: Recovery of voluntary gait after spinal cord injury (SCI) requires the restoration of effective motor cortical commands, either by means of a mechanical connection to the limbs, or by restored functional connections to muscles. The latter approach might use functional electrical stimulation (FES), driven by cortical activity, to restore voluntary movements. Moreover, there is evidence that this peripheral stimulation, synchronized with patients' voluntary effort, can strengthen descending projections and recovery...
February 12, 2019: Journal of Neural Engineering
Daisuke Kaneyuki, Toshihisa Asakura, Atsushi Iguchi, Akihiro Yoshitake, Chiho Tokunaga, Masato Tochii, Hiroyuki Nakajima
OBJECTIVES: Endovascular repair has been proposed as an alternative to classical surgical repair for the management of blunt traumatic thoracic aortic injury. However, the long-term outcomes of endovascular repair and the risks of left subclavian coverage remain unclear. METHODS: From April 2001 to August 2018, 33 patients with blunt traumatic thoracic aortic injury underwent endovascular repair in our institution. A follow-up computed tomography and a clinical examination were performed before discharge and at 1 month, and yearly or every 2 years thereafter...
February 7, 2019: European Journal of Cardio-thoracic Surgery
Sabine Wipper, Tilo Kölbel, Harleen K Sandhu, Daniel Manzoni, Anna Duprée, Anthony L Estrera, Hazim Safi, Charles C Miller, Nikolaos Tsilimparis, E Sebastian Debus
OBJECTIVES: SPIDER-graft for thoracoabdominal aortic aneurysm repair avoiding thoracotomy and extracorporeal circulation was modified, enabling reimplantation of lumbar arteries to prevent spinal cord ischemia and compared with open aortic repair (control) in a pig model. METHODS: Graft implantation was performed in 7 pigs per group (75-85 kg). For SPIDER-graft (groups I and II), the infra-diaphragmatic aorta was exposed through retroperitoneal access. The right iliac branch was first temporarily anastomosed end-to-side to the distal aorta maintaining periprocedural retrograde visceral perfusion...
December 15, 2018: Journal of Thoracic and Cardiovascular Surgery
Philippe Rigoard, Surajit Basu, Mehul Desai, Rod Taylor, Lieven Annemans, Ye Tan, Mary Jo Johnson, Carine Van den Abeele, Richard North
Despite optimal medical management (OMM), low back pain (LBP) can be disabling, particularly after spinal surgery. Spinal cord stimulation (SCS) is effective in reducing neuropathic leg pain; however, evidence is limited for LBP.This prospective, open-label, parallel-group trial randomized (1:1) failed back surgery syndrome (FBSS) patients with predominant LBP to SCS plus OMM (SCS group) or OMM alone (OMM group) in 28 sites in Europe and the Americas. If trial stimulation was successful, a SCS system was implanted...
February 1, 2019: Pain
Robert J Carrasquillo, Ricardo M Munarriz, Martin S Gross
PURPOSE OF REVIEW: The purpose of this review is to critically analyze and summarize recent studies in the area of penile prosthesis surgery outcomes with a focus on infection prevention in high-risk patients. RECENT FINDINGS: Reduction of surgical time in complex prosthesis surgery may reduce infection risk. Concomitant implant surgery is not associated with increased infection risk. Certain immunocompromised patients may be more likely to have penile implant infections, but these may not include patients with well-controlled HIV, well-controlled diabetes, or transplant recipients...
February 1, 2019: Current Urology Reports
Andres L Maldonado-Naranjo, Joshua Golubovsky, Leonardo A Frizon, Olivia Hogue, Darlene A Lobel, Andre G Machado, Michael P Steinmetz, Sean J Nagel
OBJECTIVE: Spinal cord stimulation (SCS) is both relatively safe and reversible. Although SCS is generally regarded as a last resort, some of these patients will have additional spinal surgery after the device is implanted or following its removal. The following is a descriptive study of subsequent spinal surgery following SCS. MATERIALS AND METHODS: A retrospective review of patients who had percutaneous or paddle SCS leads placed at our institution between 2009 and 2016 was performed...
January 28, 2019: World Neurosurgery
Marian H Hettiaratchi, Matthew J O'Meara, Carter J Teal, Samantha L Payne, Andrew J Pickering, Molly S Shoichet
Central nervous system (CNS) injuries, such as stroke and spinal cord injuries, result in the formation of a proteoglycan-rich glial scar, which acts as a barrier to axonal regrowth and limits the regenerative capacity of the CNS. Chondroitinase ABC (ChABC) is a potent bacterial enzyme that degrades the chondroitin sulfate proteoglycan (CSPG) component of the glial scar and promotes tissue recovery; however, its use is significantly limited by its inherent instability at physiological temperatures. Here, we demonstrate that ChABC can be stabilized using site-directed mutagenesis and covalent modification with poly(ethylene glycol) chains (i...
January 25, 2019: Journal of Controlled Release: Official Journal of the Controlled Release Society
Wenwen Huo, Yue Liu, Yishan Lei, Ying Zhang, Yulin Huang, Yanting Mao, Chenchen Wang, Yu'e Sun, Wei Zhang, Zhengliang Ma, Xiaoping Gu
Increasing evidence suggests that T cells participate in the pathology of neuropathic pain, as well as the activation of microglia. However, whether T cells infiltrate into the spinal cord and contribute to the development of bone cancer pain (BCP) remains unknown. Here, we used a mouse model of BCP to show that numbers of T cells infiltrated into the spinal cord after sarcoma cell implantation with increased BCP, and most infiltrating T cells in the spinal cord were CD3+ CD4+ T cells. Both Th17 and Treg subpopulations were analyzed by immunofluorescence...
January 24, 2019: Brain, Behavior, and Immunity
Daniel J Pak, Jesse Gruber, Timothy Deer, David Provenzano, Amitabh Gulati, Yifan Xu, Virginia Tangel, Neel Mehta
BACKGROUND AND OBJECTIVES: With a growing need for non-opioid chronic pain treatments, pain physicians should understand the proper utilization of neuromodulation therapies to provide the most comprehensive care. We aimed to identify the unmet training needs that deter physicians from using spinal cord stimulation (SCS) devices. METHODS: Internet-based surveys were fielded to fellows enrolled in pain fellowships during the 2016-2017 academic year accredited by the Accreditation Council for Graduate Medical Education and past pain fellows identified through pain medicine societies and SCS manufacturers...
January 22, 2019: Regional Anesthesia and Pain Medicine
Su Jung Lee, Yeong Min Yoo, Jun A You, Sang Wook Shin, Tae Kyun Kim, Salahadin Abdi, Kyung Hoon Kim
Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain...
January 2019: Korean Journal of Pain
David Darrow, David Young Balser, Theoden Netoff, Andrei V Krassioukov, Aaron A Phillips, Ann M Parr, Uzma Samadani
Epidural Spinal Cord Stimulation (eSCS) in combination with extensive rehabilitation has been reported to restore volitional movement in a select group of subjects after motor-complete spinal cord injury (SCI). Numerous questions about the generalizability of these findings to patients with longer term SCI have arisen, especially regarding the possibility of restoring autonomic function. To better understand the effect of eSCS on volitional movement and autonomic function, two female participants five and ten years after injury at ages 48 and 52 respectively with minimal spinal cord preservation on MRI were implanted with an eSCS system at the vertebral T12 level...
January 22, 2019: Journal of Neurotrauma
Efrat Ariel, Motti Ratmansky, Yechiel Levkovitz, Itay Goor-Aryeh
Background: Electrotherapy provides a wide range of treatment alternatives for musculoskeletal pathologies. However, for the electrical stimulation to exert a significant therapeutic effect, the induced current must often penetrate deep inside the target tissue. Objective: The objective was to systematically compare the penetration efficiency of 3 electrotherapeutic stimulation modalities: transcutaneous electrical nerve stimulation (TENS), interferential (IF) stimulation, and combined therapy with pulsed ultrasound and IF current (CTPI)...
January 17, 2019: Physical Therapy
Serban Negoita, Phan Q Duy, Uma V Mahajan, William S Anderson
We performed a retrospective study to characterize the timing and prevalence of revision and removal surgeries after spinal cord stimulator (SCS) implantation in patients with chronic pain. In our analysis of 100 patients who had SCS implants, we found that 34% of patients underwent revision surgery and 53% of patients had their implant removed. Of the patients who required revision surgeries, the majority (56%) eventually opted for removal of their SCS system. The median time to the first revision surgery was 16 months post implantation and the median time to removal was 39 months post implantation...
January 14, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jiri Ruzicka, Nataliya Romanyuk, Klara Jirakova, Ales Hejcl, Olga Janouskova, Lucia Urdzikova Machova, Marcel Bochin, Martin Pradny, Lydia Vargova, Pavla Jendelova
Spinal cord injury (SCI), is a devastating condition leading to the loss of locomotor and sensory function below the injured segment. Despite some progress in acute SCI treatment using stem cells and biomaterials, chronic SCI remains to be addressed. We have assessed the use of laminin-coated hydrogel with dual porosity, seeded with induced pluripotent stem cell-derived neural progenitors (iPSC-NPs), in a rat model of chronic SCI. iPSC-NPs cultured for 3 weeks in hydrogel in vitro were positive for nestin, glial fibrillary acidic protein (GFAP) and microtubule-associated protein 2 (MAP2)...
January 18, 2019: Cell Transplantation
Brian V Lien, Mark H Tuszynski, Paul Lu
Neural stem cells (NSCs) can differentiate into both neurons and glia after transplantation into spinal cord injury (SCI) sites. The neuronal component of stem cell grafts has the potential to form functional synaptic relays across the lesion site. The glial component may reform a blood-spinal cord barrier, support neuronal function, and contribute to remyelination. We performed a long-term, 1.5-year time course study focused on astrocyte migration, differentiation, integration, and safety following human NSC transplantation into C5 hemisection sites in immunodeficient rats...
January 14, 2019: Experimental Neurology
Jacob Koffler, Wei Zhu, Xin Qu, Oleksandr Platoshyn, Jennifer N Dulin, John Brock, Lori Graham, Paul Lu, Jeff Sakamoto, Martin Marsala, Shaochen Chen, Mark H Tuszynski
Current methods for bioprinting functional tissue lack appropriate biofabrication techniques to build complex 3D microarchitectures essential for guiding cell growth and promoting tissue maturation1 . 3D printing of central nervous system (CNS) structures has not been accomplished, possibly owing to the complexity of CNS architecture. Here, we report the use of a microscale continuous projection printing method (μCPP) to create a complex CNS structure for regenerative medicine applications in the spinal cord...
January 14, 2019: Nature Medicine
Leonardo Kapural, Shervin Harandi
BACKGROUND AND OBJECTIVE: We investigated whether an effective long-term pain relief could be achieved using subthreshold 1-1.2 kHz spinal cord stimulation (SCS) among patients who were initially implanted with traditional paresthesia-based SCS but who failed to maintain an adequate pain relief. METHODS: Retrospective chart review was conducted of patients' electronic records who underwent a trial of subthreshold 1-1.2 kHz SCS. One hundred and nine patients implanted and programmed at traditional paresthesia-based frequencies 40-90 Hz (low-frequency SCS) with unsatisfactory pain relief or unpleasant paresthesias were identified...
January 2019: Regional Anesthesia and Pain Medicine
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