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Background: Spinal cord stimulation (SCS) is an established treatment modality for neuropathic pain. The critical part of this technique is safe access to the epidural space for lead placement. There have been innovations in radiological views, improving access to the epidural space.
Objectives: This study analyzes the adoption of these technical advantages in daily practice.
Methods: We conducted a survey of members in the Spine Intervention Society and American Society of Regional Anesthesia in regard to the practice patterns in SCS therapy. Here we present our findings regarding the use of contralateral oblique (CLO) and lateral views as well direct upper thoracic or cervicothoracic access for SCS lead insertion.
Results: A total of 195 unique responses were received between March 20, 2020 and June 26, 2020. Forty-five percent of respondents "always used" the lateral view technique while 15% "always used" CLO view for SCS lead insertion. Overall, sixty-five percent of respondents used the CLO view with varying frequency. Cervical and upper thoracic approach for cervical SCS lead placement is always or often used by 66.8% of the respondents.
Conclusions: A depth view (CLO or lateral) is always used by only 45 - 60% of the respondents and CLO view has been rapidly adopted in clinical practice for SCS lead insertion. Direct cervicothoracic and upper thoracic is the preferred approach for cervical lead placement by the majority.
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http://dx.doi.org/10.5812/aapm.123357 | DOI Listing |
Pain Med
September 2025
Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA.
Objective: Introduced in 1970s, Spinal Cord Stimulator (SCS) devices have played a crucial role in managing a wide range of complex and refractory chronic pain, particularly back/leg pain as well as neuropathic pain. Currently, two primary types of leads, cylindrical and paddle leads, are prevalent in pain management. While both effectively alleviate pain, cylindrical leads, due to their small size, are susceptible to movement and migration as well as a smaller surface area for coverage, leading to device displacement and failure to provide pain relief.
View Article and Find Full Text PDFPain Med Case Rep
August 2025
2Department of Neurosurgery, Allegheny Health Network, Neuroscience Institute, Pittsburgh, PA.
Background: Spinal cord stimulation (SCS) involves the placement of percutaneously placed cylindrical leads or surgically placed paddle leads to deliver electrical stimulation for pain relief. Although more invasive, paddle leads have been associated with less lead migration and revision. We performed a retrospective review of a prospective database of SCS paddle lead implants performed by a single neurosurgeon.
View Article and Find Full Text PDFInterv Pain Med
September 2025
Total Spine Institute, Los Angeles, CA, USA.
Objective: To assess the effectiveness of dorsal column spinal cord stimulation (SCS) in treating persistent spinal pain syndrome - Type 2 (PSPS-T2).
Design: Systematic review.
Methods: PICOS (Population, Intervention, Comparison, Outcomes, and Studies) criteria were developed to include randomized controlled trials (RCTs) examining dorsal column stimulation for PSPS-T2 compared to conventional medical management or sham.
JMIR AI
August 2025
Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, 30625, Germany, 49 511 532 3745.
Background: Rare diseases, which affect millions of people worldwide, pose a major challenge, as it often takes years before an accurate diagnosis can be made. This delay results in substantial burdens for patients and health care systems, as misdiagnoses lead to inadequate treatment and increased costs. Artificial intelligence (AI)-powered symptom checkers (SCs) present an opportunity to flag rare diseases earlier in the diagnostic work-up.
View Article and Find Full Text PDFPLoS Negl Trop Dis
August 2025
Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, China.
Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus primarily associated with central nervous system disorders. Recent studies have indicated that JEV infection can lead to Guillain-Barré syndrome (GBS), a peripheral nervous system (PNS) disorder; however, the underlying mechanisms remain unclear. In this study, we investigated the tropism of different genotypes of JEV strains for peripheral nerves and their potential impact on peripheral nerves.
View Article and Find Full Text PDF