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Fixation of Ultrasound Transducers for Spinal Cord Neuromodulation in Mice
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Neuromodulation in Pediatrics: Case Series.

Eugene Kim1, Sean Gamble, Adina Schwartz

  • 1Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.

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Neuromodulation, including spinal cord stimulators (SCSs) and intrathecal drug delivery, effectively reduced chronic pain and improved function in pediatric patients. Careful patient selection is crucial for successful outcomes in this population.

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Area of Science:

  • Neurology
  • Pain Management
  • Pediatric Medicine

Background:

  • Neuromodulation techniques like spinal cord stimulators (SCSs) and intrathecal drug delivery systems are established treatments for chronic pain in adults.
  • There is limited research on the efficacy and safety of these neuromodulation methods in pediatric populations.

Purpose of the Study:

  • To evaluate the effectiveness of neuromodulation (SCSs and intrathecal pumps) in treating intractable chronic pain in children and adolescents.
  • To assess changes in pain scores, functional improvement, and medication use post-implantation.

Main Methods:

  • A retrospective case series of 14 pediatric patients (average age 17) who received either an SCS or an intrathecal pump between 2010 and 2016.
  • Data collected included pre- and post-implantation pain scores, functional status, and opioid consumption.

Main Results:

  • Significant improvements in pain scores (P<0.007) and functional status (79% of patients) were observed after neuromodulation device implantation.
  • Opioid use was significantly reduced post-implantation.
  • Three patients required device removal due to psychiatric comorbidities, and four experienced complications that were successfully managed.

Conclusions:

  • Neuromodulation offers a viable treatment option for select pediatric patients with chronic intractable pain.
  • Thorough understanding of the patient's condition and psychosocial context is essential for successful neuromodulation therapy in children.