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  • Title: [Neuromodulation--controlled analgesia. Criteria for long efficiency].
    Author: Isagulian ED, Shabalov VA.
    Journal: Zh Vopr Neirokhir Im N N Burdenko; 2008; (2):18-26; discussion 26-8. PubMed ID: 18720727.
    Abstract:
    In the past three decades, there have been cardinal changes in the surgical treatment of chronic pain syndromes. The early used destructive methods have been mostly substituted for surgical neuromodulation techniques. These include: (1) neurostimulation--the electric stimulation (ES) of peripheral nerves, the spinal cord, and brain; (2) intrathecal drug delivery by means of programmed pumps. Neurostimulation techniques are more frequently used in the treatment of no-cancer pain syndromes. Neurostimulation techniques are more frequently used in the treatment of no-cancer pain syndromes. Detailed analysis of our results showed that negative results and all cases with negative changes in follow-up were noted chiefly in patients with obvious and serious deafferentation signs. Testing ES is a major predictor of effectiveness for MCS. Positive results of chronic ES are observed in the vast majority of patients having good results in the postoperative testing period. Contrary to the current opinion as to worse follow-up results of chronic ES, we have seen positive changes in 5 patients followed up for about 3 years. Thus, by taking into account the high efficiency and minimal invasiveness of neurostimulation, no serious complications, as well as a possibility of improving the effectiveness of ES in a follow-up, this technique may be used as one of the first stages of surgical treatment of patients with neurogenic pain syndrome.
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