the efficacy of motor cortex stimulation for pain control
the efficacy of motor cortex stimulation for pain control
what's everyone's opinion, i was asked to try a clinical trial. i said yes
Re: the efficacy of motor cortex stimulation for pain control
What all does the study involve?
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Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: the efficacy of motor cortex stimulation for pain control
I posted a Clinical Trials participant recruiting for this a while back...
http://ubpn.org/messageboard/thread ... 392#156392
http://clinicaltrials.gov/ct/show/NCT00462566?order=3
I wrote to Robert M Brownstone, MD, PhD 902 473 6850 rob.brownstone@dal.ca 2 years ago asking him what his thoughts were on Spinal Cord Stimulators and Brachial Plexus Injuries, and he said in his opinion they are not worth it, and he forwarded me a study done on pain efficacy with SCS and it was too good... his study is different. I don't know much about it. I wish I could find that email, my computers are both fried right now, so everything is a mess. If I dig it out, I'll post it here.
Let us know what your decision is and what happens. It would help out a lot to have some first hand feedback and reports. Best of Luck!
Christopher
http://ubpn.org/messageboard/thread ... 392#156392
http://clinicaltrials.gov/ct/show/NCT00462566?order=3
I wrote to Robert M Brownstone, MD, PhD 902 473 6850 rob.brownstone@dal.ca 2 years ago asking him what his thoughts were on Spinal Cord Stimulators and Brachial Plexus Injuries, and he said in his opinion they are not worth it, and he forwarded me a study done on pain efficacy with SCS and it was too good... his study is different. I don't know much about it. I wish I could find that email, my computers are both fried right now, so everything is a mess. If I dig it out, I'll post it here.
Let us know what your decision is and what happens. It would help out a lot to have some first hand feedback and reports. Best of Luck!
Christopher
Re: the efficacy of motor cortex stimulation for pain control
It seems to me that if this trial involves a spinal cord stimulator implant for pain control, and if your nerves are avulsed from the spinal cord, that the stimulator would not be effective. The stimulation could not get from the nerves to the CNS to achieve pain relief. I'm not sure all that the trial involves.
-
Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: the efficacy of motor cortex stimulation for pain control
> It seems to me that if this trial involves a spinal
> cord stimulator implant for pain control, and if your
> nerves are avulsed from the spinal cord, that the
> stimulator would not be effective. The stimulation
> could not get from the nerves to the CNS to achieve
> pain relief. I'm not sure all that the trial
> involves.
This is a Motor Cortex implant... straight to the brain.
Some people have had success with Spinal Cord Stimulators even though they had all 5 BP nerves avulsed.
> cord stimulator implant for pain control, and if your
> nerves are avulsed from the spinal cord, that the
> stimulator would not be effective. The stimulation
> could not get from the nerves to the CNS to achieve
> pain relief. I'm not sure all that the trial
> involves.
This is a Motor Cortex implant... straight to the brain.
Some people have had success with Spinal Cord Stimulators even though they had all 5 BP nerves avulsed.
Re: the efficacy of motor cortex stimulation for pain control
Hi, Carrie just recently had her spinal cord stimulator removed. After 8 years and countless adjustments it never worked to relieve any pain. She has the classic C5-T1 avulsions.
Dick
Dick
-
Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: the efficacy of motor cortex stimulation for pain control
This just came up on the radar...
http://www.modernmedicine.com/modernmed ... ryId=40127
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Motor Cortex Stimulation Has Good Results in Chronic Pain
It is safe and effective for treatment of chronic neuropathic pain
Feb 13, 2009
FRIDAY, Feb. 13 (HealthDay News) -- Motor cortex stimulation may lead to a significant improvement in symptoms for patients who experience severe chronic neuropathic pain resistant to medical treatment, according to research published in the February issue of the Journal of Neurosurgery.
Denys Fontaine, M.D., Ph.D., of the Universitaire de Nice-Sophia Antipolis in France, and colleagues performed a systematic review of the available published literature on the use of motor cortex stimulation for chronic neuropathic pain. The efficacy of the procedure, as well as related adverse effects, was evaluated. A total of 14 studies containing 210 patients were reviewed.
Approximately half (55 percent) of the patients who underwent surgery experienced a good response to motor cortex stimulation, defined as pain relief of at least 40 to 50 percent, the researchers report. A total of 152 patients underwent a postoperative follow-up at least one year later; of these patients 45 percent experienced a good response to motor cortex stimulation, the report indicates. Patients with central pain and trigeminal neuropathic pain both experienced a good response (54 percent and 68 percent, respectively). Complications included infections and hardware-related problems, the authors note.
"Considering the encouraging results of previous series on one hand, and the invasiveness and cost of the procedure on the other, a double-blinded, placebo-controlled randomized study is now mandatory to evaluate the actual efficacy of motor cortex stimulation," Fontaine and colleagues conclude.
The published Journal of Neurosurgery Abstract
http://thejns.org/doi/abs/10.3171/2008. ... alCode=jns
http://www.modernmedicine.com/modernmed ... ryId=40127
=============================================
Motor Cortex Stimulation Has Good Results in Chronic Pain
It is safe and effective for treatment of chronic neuropathic pain
Feb 13, 2009
FRIDAY, Feb. 13 (HealthDay News) -- Motor cortex stimulation may lead to a significant improvement in symptoms for patients who experience severe chronic neuropathic pain resistant to medical treatment, according to research published in the February issue of the Journal of Neurosurgery.
Denys Fontaine, M.D., Ph.D., of the Universitaire de Nice-Sophia Antipolis in France, and colleagues performed a systematic review of the available published literature on the use of motor cortex stimulation for chronic neuropathic pain. The efficacy of the procedure, as well as related adverse effects, was evaluated. A total of 14 studies containing 210 patients were reviewed.
Approximately half (55 percent) of the patients who underwent surgery experienced a good response to motor cortex stimulation, defined as pain relief of at least 40 to 50 percent, the researchers report. A total of 152 patients underwent a postoperative follow-up at least one year later; of these patients 45 percent experienced a good response to motor cortex stimulation, the report indicates. Patients with central pain and trigeminal neuropathic pain both experienced a good response (54 percent and 68 percent, respectively). Complications included infections and hardware-related problems, the authors note.
"Considering the encouraging results of previous series on one hand, and the invasiveness and cost of the procedure on the other, a double-blinded, placebo-controlled randomized study is now mandatory to evaluate the actual efficacy of motor cortex stimulation," Fontaine and colleagues conclude.
The published Journal of Neurosurgery Abstract
http://thejns.org/doi/abs/10.3171/2008. ... alCode=jns