CRD summary The aim was to assess the cost-effectiveness of spinal cord stimulation compared with conventional medical management or reoperation, for patients with failed back surgery syndrome. The authors concluded that spinal cord stimulation was a cost-effective addition to conventional medical management and alternative to reoperation, for these patients. The methods and the reporting of th...

Paralysis of the upper extremity severely restricts independence and quality life after spinal cord injury. Regaining control hand arm movements is highest treatment priority for people with paralysis, 6-fold higher than restoring walking ability. Nevertheless, current approaches to improve function typically do not restore independence. Spinal stimulation an emerging neuromodulation strategy m...

Background Context. Orthodromic ascending somatosensory evoked potentials and antidromic descending neurogenic somatosensory evoked potentials monitor spinal cord sensory function. Transcranial motor stimulation monitors spinal cord motor function but only activates 4–5% of the motor units innervating a muscle. Therefore, 95–96% of the motor spinal cord systems activating the motor units are no...

Neuropathic pain constitutes a significant portion of chronic pain. Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain. Spinal cord stimulation constitutes a therapy alternative that, to date, remain...

Recent investigations on the spinalized frog have provided evidence suggesting that the neural circuits in the spinal cord are organized into a number of distinct functional modules. We have investigated the rule that governs the coactivation of two such modules. To this end, we have developed an experimental paradigm that involves the simultaneous stimulation of two sites in the frog's spinal ...

Stimulation of the dorsal skin with brief laser impulses easily evokes brain potentials (laser evoked potentials, LEPs). Dorsal LEPs were first used to study the conduction velocity in the human spinothalamic tract. In this study the diagnostic usefulness of this technique was assessed by recording dorsal LEPs in two patients with focal spinal cord lesions (one intrinsic and the other extrinsic...

Cortical and spinal cord plasticity may be induced with non-invasive transcranial magnetic stimulation to encourage long term potentiation or depression of neuronal circuits. Such plasticity inducing stimulation provides an attractive approach to promote changes in sensorimotor circuits that have been degraded by spinal cord injury (SCI). If residual corticospinal circuits can be conditioned ap...

The selection of proper candidates for implantable spinal cord stimulation is a critical factor for producing acceptable outcomes for patients suffering from severe pain. A device in the proper location with the appropriate programming will not be helpful if the patient is a poor candidate for the therapy or if the disease process does not respond to the application of spinal cord stimulation. ...

Transcutaneous spinal cord stimulation (SCS) is a noninvasive method to electrically stimulate afferent structures of the human lumbar spinal cord. These are the same neural targets as predominantly activated by epidural implants. Biophysical principles derived from computer simulations contributed to the identification of the directly activated neural structures. These simulations combine fini...