WCTN: World Collaborative Textbook of Neurosurgery

Authors

Kenneth M. Alo`, MD - Houston Texas Pain Management, Houston Texas
Marina V. Abramova, MD - LSU Health Sciences Center, New Orleans, Louisiana
Erich O. Richter, MD - LSU Health Sciences Center, New Orleans, Louisiana

Abstract

Since its inception in the 1970s, peripheral neuromodulation has become an increasingly common procedure to treat chronic neuropathic disorders.  Historically, peripheral nerve stimulation (PNS) originated with the placement of large surface cuff electrodes, which was refined by the introduction of functional nerve mapping with circumferential electrical stimulation.  This substantially improved the targeting of sensory fascicles.  Surgical placement of spinal cord stimulation (SCS) “button type” paddle electrodes was replaced when the introduction of percutaneous cylindrical SCS electrodes expanded the spectrum of PNS applications and improved the ability to target afferent sensory fibers as well as reducing the complication rate.  To further refine functional mapping for the placement of these percutaneous electrodes, radiofrequency needle probes have more recently been employed to elicit paresthesias in awake patients to map the pain generators and guide treatment.  In this chapter, we provide a description of the development and basic mechanisms of peripheral nerve stimulation, as well as a more detailed description of the two most commonly employed forms of peripheral nerve stimulation: occipital nerve stimulation for occipital neuralgia, and subcutaneous peripheral nerve field stimulation (PNfS) to stimulate free nerve endings within the subcutaneous tissue when the pain is limited to a small, well-localized area.  The closely related ideas of internal and external targeted subcutaneous stimulation are also discussed.

Index of Sections

Section 7.1: Introduction to Peripheral Neurostimulation
Section 7.2: Anatomy and Physiology
Section 7.3: Percutaneous Surgical Techniques
Section 7.4: Discussion and Conclusion

Tags:
Created by Max Gosey on 2010/06/11 00:00
     

Chapter List

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*New Table of Contents\

-VOLUME I: NEUROLOGY\

-*VOLUME II: GENERAL NEUROSURGERY SPACE HAS BEEN CREATED\

-VOLUME III: STEREOTACTIC AND FUNCTIONAL NEUROSURGERY yes\

-VOLUME IV: PAIN yes\

-VOLUME V: SURGERY FOR EPILEPSY SPACE HAS BEEN CREATED (but don't try to create pages, as we don't have any content to put into them yet)\

-VOLUME VI: ENDOVASCULAR NEUROSURGERY\

-VOLUME VII: NEUROLOGICAL ONCOLOGY yes\ .\ .\ -\ -\ _.\ .\ .\ .\ .\ .\ .\ .\ .\ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

-VOLUME I: FUNCTIONAL NEUROSURGERY

Chapter 9

-Chapter 10

-Chapter 11

-Chapter 12

-Chapter 13

-Chapter 14: Thalamic Ventral Intermediate Nucleus Stimulation for Essential Tremor

-VOLUME II: NEUROONCOLOGY

-Chapter 15: Histological Types of Tumors

-Chapter 16: Metastasis

-Chapter 17: Posterior Fossa Tumors

-Chapter 18: Meningiomas

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VOLUME III: GENERAL NEUROSURGERYChapter 32

-Chapter 33

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