Introduction The prevalence of chronic pain in the United States is variable; however, the burden is substantial and continues to grow. Chronic pain is defined as pain that lasts longer than 3 months or past the time of normal tissue…
Physiology and Pathophysiology of Chronic Pain Pain Pathogenesis Pain is an unpleasant sensory and emotional experience that involves complex processes of neuronal signaling in the peripheral nervous system and central nervous system (CNS). Chronic pain is defined as pain lasting…
Introduction Vagus nerve stimulation (VNS) is a treatment option for a number of disorders. It is most commonly used to treat medically intractable seizures but has also been approved by the United States Food and Drug Administration (FDA) to treat…
Introduction The provision of well-engineered, well-implanted neuroprostheses represents a major advance in the acceptability, safety, and durability of electronic controllers for paralyzed persons. Well-thought-out strategies and progressive understanding of the risks, benefits, and service and maintenance requirements of these devices…
Surgical Planning/Preoperative Considerations Planning for the implantation of an implantable drug delivery system (IDDS) requires considerations for the prevention of hardware infection, ergonomics of system function and comfort of the patient, prevention of pump pocket and catheter complications, and prevention…
Introduction Occipital electrode placement into the subcutaneous tissues, innervated by and adjacent to the greater, lesser, and/or third occipital nerves from the C2-3 nerve roots for intractable occipital headache syndromes, continues to be an evolving methodology since the first cases…
Introduction Spinal cord stimulation (SCS) has been accepted as a therapeutic modality for chronic complex pain conditions of the lumbar and cervical spine ( ). Although conventional SCS has been successful for the treatment of radicular pain, either upper extremity…
Introduction Spinal cord stimulation (SCS) provides a nondestructive and adjustable method of providing symptomatic relief of neuropathic pain across several indications. Based on Melzak and Wall’s Gate Control Theory of Pain ( ), electrical stimulation of dorsal column fibers within…
Introduction Traditionally, deep brain stimulation (DBS) has been performed by using frame-based stereotaxy in an awake patient. Frame-based stereotaxy has been the technique of choice due to its perceived superior accuracy over “frameless” approaches, while awake testing was deemed essential…
Introduction Optogenetics is defined as the use of light-based technologies that are genetically targeted to certain cellular groups or proteins ( ). In practice, optogenetics most often refers to the use of genetically modified, microbial rhodopsins (pigmented light-sensitive membrane proteins)…