The Experts below are selected from a list of 3831 Experts worldwide ranked by ideXlab platform
Claudio Yampolsky - One of the best experts on this subject based on the ideXlab platform.
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Is spinal cord stimulation safe? A review of its complications
World Neurosurgery, 2014Co-Authors: Damian Bendersky, Claudio YampolskyAbstract:Objective We aim to evaluate the complications of spinal cord stimulation (SCS). Methods This article is a nonsystematic review of literature about the safety of SCS. The complications of this technique are described, focusing the analysis in their prevention, diagnosis, and treatment. Results Electrode migration is the most common complication of SCS and it is more frequent with percutaneous electrodes than with paddle-type ones. Lead migration may be solved by reprogramming the stimulator, but if it fails, surgical repositioning is mandatory. Several anchoring techniques are described in the text. Infection is a potentially reducible complication associated with the surgical procedure and the reported infection rates are comparable with those of several neuromodulation devices. Recommendations for the prevention of SCS device infections are listed in the article. Other complications were reviewed such as electrode fracture, Extension Wire or implantable pulse generator failures, cerebrospinal fluid leakage, pain over the stimulator, and spinal epidural hematoma, among others. Conclusion In spite of the existence of several complications, SCS may be seen as a safe technique. Furthermore, the incidence of life-threatening complications is low. The physician must be alert to recognize them during the follow-up. Complications may be avoided or at least diminished by performing a proper and strict aseptic surgical technique as well as carrying out an accurate patient selection before the implantation, according to the recommendations published in the literature.
Jiten Patel - One of the best experts on this subject based on the ideXlab platform.
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microbiological evaluation of the Extension Wire and percutaneous epidural lead anchor site following a 2 stage cut down spinal cord stimulator procedure
Pain Practice, 2017Co-Authors: Abdul Ghaaliq Lalkhen, M Chincholkar, Jiten PatelAbstract:Objectives There are concerns regarding bacterial colonization of the temporary Extension leads and subsequent infection risk using the 2-stage cut-down approach in spinal cord stimulation (SCS). We sought to quantify the extent of bacterial colonization of the temporary Extension Wire and percutaneous epidural lead anchor site. Materials and Methods We conducted a cross-sectional observational study recruiting a pragmatic sample of 25 consecutive patients listed for a cut-down trial of SCS. We excluded patients undergoing revision procedures and those who had previously received a spinal cord stimulator. The primary outcome measure was the rate and type of colonization of the Extension Wires and lead anchor site. Results No surgical site infections were recorded in any of the patients and no late infections subsequent to insertion of the implantable pulse generator. Overall, 24% of patients grew organisms from the temporary Extension Wire. Five patients grew coagulase-negative Staphylococcus aureus, and 1 patient grew Enterococcus faecalis. There were no positive wound cultures from the anchor site of the epidural lead. Conclusions Despite the high colonization rate of the temporary Extension Wire, there were no surgical site infections. We conclude that provided appropriate strategies for the management of surgical site infections are implemented, the 2-stage cut-down procedure is a safe approach that is not associated with a higher incidence of infection.
Damian Bendersky - One of the best experts on this subject based on the ideXlab platform.
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Is spinal cord stimulation safe? A review of its complications
World Neurosurgery, 2014Co-Authors: Damian Bendersky, Claudio YampolskyAbstract:Objective We aim to evaluate the complications of spinal cord stimulation (SCS). Methods This article is a nonsystematic review of literature about the safety of SCS. The complications of this technique are described, focusing the analysis in their prevention, diagnosis, and treatment. Results Electrode migration is the most common complication of SCS and it is more frequent with percutaneous electrodes than with paddle-type ones. Lead migration may be solved by reprogramming the stimulator, but if it fails, surgical repositioning is mandatory. Several anchoring techniques are described in the text. Infection is a potentially reducible complication associated with the surgical procedure and the reported infection rates are comparable with those of several neuromodulation devices. Recommendations for the prevention of SCS device infections are listed in the article. Other complications were reviewed such as electrode fracture, Extension Wire or implantable pulse generator failures, cerebrospinal fluid leakage, pain over the stimulator, and spinal epidural hematoma, among others. Conclusion In spite of the existence of several complications, SCS may be seen as a safe technique. Furthermore, the incidence of life-threatening complications is low. The physician must be alert to recognize them during the follow-up. Complications may be avoided or at least diminished by performing a proper and strict aseptic surgical technique as well as carrying out an accurate patient selection before the implantation, according to the recommendations published in the literature.
Abdul Ghaaliq Lalkhen - One of the best experts on this subject based on the ideXlab platform.
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microbiological evaluation of the Extension Wire and percutaneous epidural lead anchor site following a 2 stage cut down spinal cord stimulator procedure
Pain Practice, 2017Co-Authors: Abdul Ghaaliq Lalkhen, M Chincholkar, Jiten PatelAbstract:Objectives There are concerns regarding bacterial colonization of the temporary Extension leads and subsequent infection risk using the 2-stage cut-down approach in spinal cord stimulation (SCS). We sought to quantify the extent of bacterial colonization of the temporary Extension Wire and percutaneous epidural lead anchor site. Materials and Methods We conducted a cross-sectional observational study recruiting a pragmatic sample of 25 consecutive patients listed for a cut-down trial of SCS. We excluded patients undergoing revision procedures and those who had previously received a spinal cord stimulator. The primary outcome measure was the rate and type of colonization of the Extension Wires and lead anchor site. Results No surgical site infections were recorded in any of the patients and no late infections subsequent to insertion of the implantable pulse generator. Overall, 24% of patients grew organisms from the temporary Extension Wire. Five patients grew coagulase-negative Staphylococcus aureus, and 1 patient grew Enterococcus faecalis. There were no positive wound cultures from the anchor site of the epidural lead. Conclusions Despite the high colonization rate of the temporary Extension Wire, there were no surgical site infections. We conclude that provided appropriate strategies for the management of surgical site infections are implemented, the 2-stage cut-down procedure is a safe approach that is not associated with a higher incidence of infection.
P. Charles Garell - One of the best experts on this subject based on the ideXlab platform.
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Placement of the Internal Pulse Generator for Deep Brain Stimulation in the Upper Back to Prevent Fracture of the Extension Wire due to Generator Rotation: Case Report
Parkinson's Disease, 2010Co-Authors: Ankur Garg, Avinash L. Mohan, P. Charles GarellAbstract:Deep brain stimulation (DBS) is a common surgical procedure used for the treatment of Parkinson's disease (PD) and essential tremor. A potential complication of this procedure is hardware failure. The authors report a case of DBS hardware failure in which repeated fractures of the Extension Wire were caused by abnormal rotational movements of the IPG placed in the loose subclavicular tissue of an overweight female. Implantation of the IPG in the suprascapular area prevented further Extension Wire fractures. This strategy may be especially relevant in overweight females with loose subclavicular tissue.
