Migration risk Physician action Fatty tissue at anchoring site Debride fatty tissue around the needle entry site exposing fascia and ligament for proper anchoring Anchoring to muscle When using an…
Fig. 43.1 Intrathecal drug delivery may have advantages to systemic drug delivery The reported incidence of adverse events range from 3 to 24 %, most of which are minor and…
Fig. 39.1 Marking the skin for the tunneling course using the two-step technique Fig. 39.2 Local anesthesia for tunneling Once the patient has been properly anesthetized by using local anesthesia…
Fig. 10.1 Anchoring and suturing technique. Proper needle placement (a). Proper placement of the surgical lead (b). Proper placement of the anchoring device at the fascia entry point (c). Suturing…
Complication Diagnosis of problem Treatment of problem Neuraxis complications Nerve injury CT or MRI, EMG/NCS/physical exam Steroid protocol, anticonvulsants, neurosurgery consult Epidural fibrosis Increased stimulation amplitude Lead reprogramming, lead revision…
Fig. 40.1 Langer’s lines Knowing the direction of Langer’s lines within a specific area of the skin is important for surgical operations, particularly cosmetic surgery. If a surgeon has a…
Neuropathies: diabetic, alcohol-induced, metabolic, nutritional deficiency, heavy metal, chemotherapy-induced, idiopathic, infectious (HIV, syphilis) Spine-induced pain: disc impingement of the nerve, foraminal narrowing, central stenosis, epidural fibrosis, arachnoiditis, mechanical entrapment of…
Fig. 11.1 The course of tunneling is planned based on landmarks and the best direction for placing the tunneling tool Fig. 11.2 Local anesthesia placed along the tract for tunneling…
Inclusion criteria Amputation of lower or upper limb Chronic pain from amputation for ≥6 months Pain refractory to conventional medical management Severe pain in an amputated limb (worst pain intensity…
Fig. 23.1 Location of the dorsal root ganglion (DRG) as compared to the pedicle Fig. 23.2 Radiographic of DRG location. Blue indicates pedicle; red indicates neuroforamen; yellow indicates DRG Using…
