Introduction As neuromodulation therapies become a treatment standard for a variety of disorders including medically refractory Parkinson's disease (PD), essential tremor, dystonia, pain syndromes, epilepsy, psychiatric disorders, and other future indications, more is being learned about the longevity and function…
Disclosures Dr. Pilitsis is a consultant for Boston Scientific, Nevro, TerSera, and Abbott and receives grant support from Medtronic, Boston Scientific, Abbott, Nevro, TerSera, NIH 2R01CA166379-06 and NIH U44NS115111. She is medical advisor for Aim Medical Robotics and Karuna and…
Background Spinal cord stimulation (SCS) has been employed for the treatment of intractable pain most commonly for failed back surgery syndrome and complex regional pain syndromes. It is generally accepted that for successful SCS treatment there is the superposition of…
Introduction Implantable Devices have seen major increases in technology and complexity over the past decade. Fortunately, this has not changed our ability to “Test Drive” our devices. Unlike other interventional or minimally invasive procedures, our patients have the advantage of…
Introduction Paying proper attention to all technical aspects of neurostimulation device implantation makes all the difference in the long-term patient outcome with these devices. If these are truly going to be less invasive therapies, then the experience of undergoing implantation…
Overview All neurostimulators require an energy source to generate the electric fields which modulate the nervous system. The choice of technologies to power neurostimulators has a greater impact on the device design than any other choice. The use of an…
Introduction Neurostimulators can be generally categorized as either external or fully implantable. The former has a longer history because external neurostimulators do not have the design and operational challenges of limited power sources, convenient size, hermeticity, and control interfaces among…
Introduction A neuromodulation system may consist of two or more components, including the implantable pulse generator (IPG) and a therapy lead which delivers stimulation to the underlying neural tissue. The leads direct energy from the pulse generator to the target…
Introduction Neuromodulation requires a means of affecting the function of neurons and/or axons. This can be achieved by physical means such as changing temperature or mechanical pressure. Manipulation of the chemical environment by changing pH, ionic concentration, or the release…
Introduction All of neuromodulation is dependent on the delivery of a waveform comprised of electromagnetic fields to nervous system tissues in the human body. We are setting aside for now the types of neuromodulation working within the realm of light,…