Journal of Nippon Medical School: Vol.67 No.1 page.013

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ArticleTitle The clinical efficacy of neuroendoscope in surgical treatment for deafferentation pain

AuthorList Takayuki Kitamura and Akira Taramoto

Affiliation Department of Neurosurgery, Nippon Medical School

Language EN

Volume 67

Issue 1

Year 2000

Page 13-17

Received September 10, 1999

Accepted October 19, 1999

Keywords endoscopy, spinal cord, thalamic hemorrhage, deafferentation pain, electrical stimulation

Abstract Spinal cord stimulation (SCS) is one of the most minimally invasive and effective treatments for intractable pain. We report the efficacy of a very small diameter neuroendoscope on setting the electrode to the proper site in the epidural space. Our cases include thalamic hemorrhage, and each patient had unilateral intractable pain on L1 or less as the main complaint. They had been treated for over two years in other hospitals, but no significant relief was achieved. Because each patient had been given frequent epidural blocks, the adhesion in the epidural space was expected. In Group A (3 cases), we used very small diameter neuroendoscope to dissect adhesion in the epidural space and to make optimal space for lead placement under direct vision. Conventional lead placement under fluoroscopy was performed in Group B (3 cases). Medtronic's PISCES lead system was used for SCS. In Group A, stimulation and pain regions matched in all cases, and good pain relief was also achieved. In Group B, however, stimulation and pain regions matched incompletely and the increase in stimulation caused stimulation on the pain-free side.

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ArticleTitle	The clinical efficacy of neuroendoscope in surgical treatment for deafferentation pain
AuthorList	Takayuki Kitamura and Akira Taramoto
Affiliation	Department of Neurosurgery, Nippon Medical School
Language	EN
Volume	67
Issue	1
Year	2000
Page	13-17
Received	September 10, 1999
Accepted	October 19, 1999
Keywords	endoscopy, spinal cord, thalamic hemorrhage, deafferentation pain, electrical stimulation
Abstract	Spinal cord stimulation (SCS) is one of the most minimally invasive and effective treatments for intractable pain. We report the efficacy of a very small diameter neuroendoscope on setting the electrode to the proper site in the epidural space. Our cases include thalamic hemorrhage, and each patient had unilateral intractable pain on L1 or less as the main complaint. They had been treated for over two years in other hospitals, but no significant relief was achieved. Because each patient had been given frequent epidural blocks, the adhesion in the epidural space was expected. In Group A (3 cases), we used very small diameter neuroendoscope to dissect adhesion in the epidural space and to make optimal space for lead placement under direct vision. Conventional lead placement under fluoroscopy was performed in Group B (3 cases). Medtronic's PISCES lead system was used for SCS. In Group A, stimulation and pain regions matched in all cases, and good pain relief was also achieved. In Group B, however, stimulation and pain regions matched incompletely and the increase in stimulation caused stimulation on the pain-free side.
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