(1) IPM Medical Group, Inc., Walnut Creek, CA, USA   KeywordsChronic painNeuromodulationSpinal cordStimulationIntrathecal drug deliveryPumpAxial painLow back painLimb painTonicHF10 therapyBurstDorsal root ganglionPost-lumbar laminectomyFBSSRadiculopathy Key Points Neuromodulation is quickly evolving to…

Fever or chills Trauma Unexplained weight loss Osteoporosis History of cancer History of ankylosing spondylitis History of intravenous drug abuse Bowel of bladder changes Recent infection Upper of lower extremity…

Fig. 20.1 Utility of MRI. (a) T1 MRI shows low attenuation in the acute L2 vertebral body fracture. (b) T2 MRI shows altered signal in the L2 vertebral body. (c)…

Fig. 17.1 Example of regional peripheral stimulation (in this case for axial thoracic pain). The two sets of electrodes have been inserted subcutaneously along the length of the demarcated lateral…

Fig. 21.1 Comparison of traditional and burst stimulation waveforms. Courtesy of St. Jude Medical Burst stimulation has been studied extensively. In a double-blind placebo-controlled trial comparing tonic stimulation with burst…

For the case of this example , let’s assume that the patient has axial back pain with unilateral lower extremity radicular complaints and no weakness, or numbness, and is 2…

1. Calculate total mg dose taken in past 24-h. 2. Determine equi-analgesic dose (table). 3. If pain is controlled on current opioid, reduce the new opioid daily dose by 30–50…