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首页> 外文期刊>Neurosurgical focus >Novel technique for trialing peripheral nerve stimulation: ultrasonography-guided StimuCath trial
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Novel technique for trialing peripheral nerve stimulation: ultrasonography-guided StimuCath trial

机译：试验周围神经刺激的新技术：超声引导下的StimuCath试验

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OBJECTIVE Peripheral nerve stimulation (PNS) has been used for the treatment of neuropathic pain for many decades. Despite the specific indications for PNS, clinicians often have difficulty screening for candidates likely to have a good or fair outcome. Given the expense of a permanent implant, most insurance companies will not pay for the implant without a successful PNS trial. And since PNS has only recently been approved by the US Food and Drug Administration, many insurance companies will not pay for a conventional trial of PNS. The objective of this study is to describe a short low-cost method for trialing and screening patients for peripheral nerve stimulator implantation. Additionally, this study demonstrates the long-term efficacy of PNS in the treatment of chronic neuropathic pain and the relative effectiveness of this novel screening method. METHODS The records of all patients who had undergone trialing and implantation of a PNS system for chronic refractory pain at the authors' institution over a 1-year period (August 1, 2012–July 31, 2013) were examined in this retrospective case series. The search revealed 17 patients, 13 who had undergone a novel in-office ultrasonography-guided StimuCath screening technique and 4 who had undergone a traditional week-long screening procedure. All 17 patients experienced a successful PNS trial and proceeded to permanent PNS system implantation. Patients were followed up for a mean duration of 3.0 years. Visual analog scale (VAS) pain scores were used to assess pain relief in the short-term ( RESULTS Of these 17 patients, 10 were still using their stimulator at the last follow-up, with 8 of them obtaining good relief (classified as ≥ 50% pain relief, with an average 81% reduction in the VAS score) and 2 patients attaining fair relief ( CONCLUSIONS Short, ultrasonography-guided StimuCath trials were feasible in screening patients for permanent implantation of PNS, with efficacy similar to the traditional week-long screening noted at the 3-year follow-up.
机译：目的周围神经刺激（PNS）已用于治疗神经性疼痛已有数十年历史。尽管有PNS的具体适应症，但临床医生通常难以筛选出可能具有良好或公正结果的候选人。考虑到永久性植入物的费用，如果没有成功的PNS试验，大多数保险公司将不会支付植入物的费用。而且由于PNS直到最近才获得美国食品和药物管理局的批准，因此许多保险公司不会为PNS的常规试验付费。这项研究的目的是描述一种简短的低成本方法，用于试验和筛查患者是否需要植入周围神经刺激器。此外，这项研究证明了PNS在治疗慢性神经性疼痛方面的长期疗效以及这种新型筛查方法的相对有效性。方法在此回顾性病例系列中，检查了在作者所在机构进行为期1年（2012年8月1日至2013年7月31日）的慢性顽固性疼痛的PNS系统的试验和植入的所有患者的记录。搜寻发现17例患者，其中13例接受了新的办公室超声检查指导的StimuCath筛查技术，还有4例接受了传统的为期一周的筛查程序。所有17例患者均经历了成功的PNS试验，并进行了永久性PNS系统植入。对患者进行平均3.0年的随访。视觉模拟量表（VAS）疼痛评分用于评估短期内的疼痛缓解（结果）这17例患者中，有10例在最后一次随访中仍在使用刺激器，其中8例获得了良好的缓解（分类为≥疼痛减轻50％，VAS评分平均降低81％），并且2名患者获得了明显缓解（结论，超声引导下的StimuCath短期试验对筛查永久性PNS植入患者的筛查是可行的，其效果与传统的每周相似在3年的随访中进行了长期筛查。

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