scholarly journals Evaluation of Interaction between a Spinal Cord Stimulator and Implanted CardioverterDefibrillator in a Swine Model

2013 ◽  
Vol 5;16 (5;9) ◽  
pp. 489-496
Author(s):  
Gassan M. Chaiban
Keyword(s):  
Spinal Cord ◽  
Right Ventricle ◽  
Epidural Space ◽  
Pulse Generator ◽  
Swine Model ◽  
Boston Scientific ◽  
Spinal Cord Stimulator ◽  
Electrode Lead ◽  
Chronic Pain Conditions ◽  
The Right

Background: Spinal cord stimulators (SCS) have been used for many years to treat a myriad of chronic pain conditions using electrical signals to diminish the perception of a painful stimulus. Because of the electrical nature of the devices, there is a concern about the potential for electromagnetic interaction between the device and lifesaving cardiac implantable cardiovertersdefibrillators (ICVD). Objective: The purpose of this study was to use a swine model to evaluate the potential for interaction between an implanted SCS and ICVD using the closest possible proximity, highest stimulation settings, and most sensitive ICVD settings. Methods: A pig was anesthetized and subsequently an ICVD and ICVD lead (Cogni 100-D and Endotak Reliance®, Boston Scientific, Natick, MA) were placed into the right prepectoral region and the right ventricle, respectively. An SCS (50 cm linear ST Precision Plu octad electrode lead [Boston Scientific, Valencia, CA] with 3 mm wide contacts spaced one mm apart) was implanted using fluoroscopic guidance into the posterior epidural space. Remote interrogation and programming of the ICVD were performed while the SCS lead was placed in as close proximity as possible, using fluoroscopy to guide the final position of the SCS electrode. After confirming that both systems were working, appropriately 9 stimulating configurations of varying current, pulse width, and frequency, including maximal settings, were delivered through the SCS. The effects on the ICVD were recorded at 2 sensitivity settings. Results: None of the tested SCS configurations caused interference with the proper functioning of the ICVD. Limitations: The anatomical proximity of the posterior epidural space and right ventricle of the swine is different from humans. While the entire pacer, including generator, was imbedded in a subcutaneous pocket, an implantable pulse generator for the SCS was not implanted, which did not allow us to study if any damage or a resetting of settings had occurred to the generator. Only one manufacturer was used in this study. Also, this study was performed in an anesthetized pig and the anatomical positions remained static. Realistically, changes in position of the devices would occur in patients who perform activities of daily living, and this can potentially shorten the distance between the 2 leads causing adverse interaction. Conclusion: This study clearly demonstrated the feasibility of the 2 devices coexisting and functioning appropriately in an animal model using an ICVD and SCS donated by Boston Scientific. Further studies are needed to elucidate restrictions, optimal settings and parameters in a human setting. Key words: Spinal cord stimulator, interaction, implantable cardioverter defibrillator, pacemaker, swine model, cross-talk.

scholarly journals A Fully Implantable Miniaturized Liquid Crystal Polymer (LCP)-Based Spinal Cord Stimulator for Pain Control

Sensors ◽  
2022 ◽  
Vol 22 (2) ◽  
pp. 501
Author(s):  
Seunghyeon Yun ◽  
Chin Su Koh ◽  
Jungmin Seo ◽  
Shinyong Shim ◽  
Minkyung Park ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
Liquid Crystal ◽  
Mechanical Stimulation ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Spinal Cord Stimulator ◽  
Stimulation Threshold ◽  
Crystal Polymer ◽  
Stimulation Of

Spinal cord stimulation is a therapy to treat the severe neuropathic pain by suppressing the pain signal via electrical stimulation of the spinal cord. The conventional metal packaged and battery-operated implantable pulse generator (IPG) produces electrical pulses to stimulate the spinal cord. Despite its stable operation after implantation, the implantation site is limited due to its bulky size and heavy weight. Wireless communications including wireless power charging is also restricted, which is mainly attributed to the electromagnetic shielding of the metal package. To overcome these limitations, here, we developed a fully implantable miniaturized spinal cord stimulator based on a biocompatible liquid crystal polymer (LCP). The fabrication of electrode arrays in the LCP substrate and monolithically encapsulating the circuitries using LCP packaging reduces the weight (0.4 g) and the size (the width, length, and thickness are 25.3, 9.3, and 1.9 mm, respectively). An inductive link was utilized to wirelessly transfer the power and the data to implanted circuitries to generate the stimulus pulse. Prior to implantation of the device, operation of the pulse generator was evaluated, and characteristics of stimulation electrode such as an electrochemical impedance spectroscopy (EIS) were measured. The LCP-based spinal cord stimulator was implanted into the spared nerve injury rat model. The degree of pain suppression upon spinal cord stimulation was assessed via the Von Frey test where the mechanical stimulation threshold was evaluated by monitoring the paw withdrawal responses. With no spinal cord stimulation, the mechanical stimulation threshold was observed as 1.47 ± 0.623 g, whereas the stimulation threshold was increased to 12.7 ± 4.00 g after spinal cord stimulation, confirming the efficacy of pain suppression via electrical stimulation of the spinal cord. This LCP-based spinal cord stimulator opens new avenues for the development of a miniaturized but still effective spinal cord stimulator.

Management of incidental lumboiliac hernia during spinal cord stimulator implant: a case report

2019 ◽  
Vol 44 (11) ◽  
pp. 1033-1034
Author(s):  
David Hao ◽  
Charles Odonkor ◽  
Shane Volney ◽  
Mihir Kamdar ◽  
Shihab Ahmed
Keyword(s):  
Spinal Cord ◽  
Pulse Generator ◽  
Incidental Finding ◽  
Correct Diagnosis ◽  
Synthetic Mesh ◽  
Lumbar Hernia ◽  
Spinal Cord Stimulator ◽  
Operative Repair ◽  
Lumbar Triangle

Lumboiliac or lumbar hernia is a rare defect in the posterolateral abdominal wall that may be inadvertently misidentified and interfere with the implantable pulse generator (IPG) portion of spinal cord stimulator (SCS) implants. We report the case of a 54-year-old Caucasian man with an incidental finding of a lumboiliac hernia in the inferior lumbar triangle of Petit with placement of an IPG in a SCS implant. With the assistance of surgical colleagues, the correct diagnosis was made intraoperatively. We describe the operative repair of the lumboiliac hernia with a synthetic mesh. A new IPG pocket was created above the mesh prior to proceeding with IPG placement. No recurrence of the hernia defect was observed on 2-month follow-up. It is important that pain physicians and neurosurgeons who perform SCS implants are aware of lumboiliac hernias to avoid potential diagnostic or management errors. Lumboiliac hernias should be included on the differential diagnosis of lumbar or flank masses. Confirmation with imaging may be necessary and definitive surgical treatment should be pursued.

Microvascular obstruction in the right ventricle in reperfused anterior myocardial infarction. Macroscopic and pathologic evidence in a swine model

2013 ◽  
Vol 132 (5) ◽  
pp. 592-598 ◽  
Author(s):  
Clara Bonanad ◽  
Amparo Ruiz-Sauri ◽  
Maria J Forteza ◽  
Fabian Chaustre ◽  
Gema Minana ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricle ◽  
Microvascular Obstruction ◽  
Swine Model ◽  
Anterior Myocardial Infarction ◽  
The Right

Potential for Disruption of Central Nervous System Tissue in Beef Cattle by Different Types of Captive Bolt Stunners

1999 ◽  
Vol 62 (4) ◽  
pp. 390-393 ◽  
Author(s):  
G. R. SCHMIDT ◽  
K. L. HOSSNER ◽  
R. S. YEMM ◽  
D. H. GOULD
Keyword(s):  
United States ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Right Ventricle ◽  
Air Injection ◽  
Central Nervous System Tissue ◽  
Different Types ◽  
Central United States ◽  
The Right

The application of pneumatic-powered air injection stunners (PPAISs), pneumatic-powered stunners (PPSs), and cartridge-fired stunners (CFSs) in commercial beef slaughter plants was evaluated to determine the extent of dissemination of central nervous system tissue. Fifteen beef slaughter plants in the western and central United States were visited to observe stunning methods and the condition of the hearts at postmortem inspection. As inspectors performed the normal opening of the hearts, the research observer evaluated the contents of the heart for the presence of clots and/or visible tissue segments in the right ventricle. In eight plants where PPAISs were used, 33% of hearts examined (n = 1,050) contained large clots in the right ventricles. In the four plants where CFSs were used, 1% of the hearts (n = 480) contained detectable clots. In three plants where the newly modified PPSs were used, 12% of the hearts (n = 450) contained detectable clots. Large segments of spinal cord were detected, collected, photographed, and confirmed histologically from two hearts in a plant that used a PPAIS. Most of the material was found in a single right ventricle and was composed of 10 to 13 cm segments of spinal cord.

Experience of Right Leg Pain Control by Left Epidural Space Inserted Spinal Cord Stimulator -A case report-

2005 ◽  
Vol 18 (2) ◽  
pp. 214
Author(s):  
Bum Jin Kim ◽  
Woo Yong Lee ◽  
Seung Hoon Woo ◽  
Ki Hyeok Hong
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Epidural Space ◽  
Pain Control ◽  
Leg Pain ◽  
Spinal Cord Stimulator

scholarly journals Unexpected extrusion of the implantable pulse generator of the spinal cord stimulator - A case report -

2021 ◽  
Vol 16 (1) ◽  
pp. 103-107
Author(s):  
Eun-Ji Choi ◽  
Hyun-Su Ri ◽  
Hyeonsoo Park ◽  
Hye-Jin Kim ◽  
Ji-Uk Yoon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pulse Generator ◽  
Pain Syndrome ◽  
Lower Abdomen ◽  
Local Pain ◽  
Implantable Pulse Generator ◽  
Technological Advances ◽  
Pressure Necrosis ◽  
The Right ◽  
Car Accident

Background: Despite significant technological advances in the implantable pulse generator (IPG), complications can still occur. We report a case that unexpected extrusion of the IPG of spinal cord stimulation (SCS) was promptly identified and successfully removed without any complications. Case: After a car accident 4 years ago, a 55-year-old man who was diagnosed with complex local pain syndrome in his right leg. The SCS was inserted with 2 leads, with the IPG being implanted in the right lower abdomen region. Four years later, he developed extrusion of the IPG from his abdominal region. This unexpected extrusion may have been related to pressure necrosis caused by continued compression of pocket site where a belt was frequently tied. The IPG and the leads were successfully removed without infection occurring. Conclusions: To prevent unexpected extrusion of IPG, it is necessary to consider in advance whether the pocket site is pressed against the belt.

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