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Long-term pain control by direct peripheral-nerve stimulation.
Abstract
In 1970, we began implanting electrodes for prolonged stimulation of injured peripheral nerves to reduce chronic pain. Thirty-eight peripheral nerves in thirty-five patients have been stimulated with electrodes for a period ranging from four to nine years. Nineteen electrode systems were implanted in the upper extremity (eleven on the median nerve, six on the ulnar nerve, one on the median and ulnar nerves, and one on the median and radial nerves), with successful relief of pain in 52..6 per cent of the patients. Sixteen stimulators have been implanted on the sciatic nerve with a success rate for pain relief of 31 per cent. Failures in the lower extremity were found primarily in lesions of the posterior tibial nerve at the ankle. We speculate that the stress of weight-bearing and the anatomical position of the posterior tibial nerve may partially account for this rate of failure. Use of the electrode-implant systems required careful preoperative assessment by an experienced team, meticulous technique, and a mechanical system that tolerates stress. The location and characteristics of the lesion affect the response to electrical stimulation.
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“for reducing pain”
From A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems (2005) · cites this paper as Nashold et al., 1982
In the citing paper
“up to 8 years stimulating the median, radial, sciatic, and ulnar nerves [39]”
From Safety of long-term electrical peripheral nerve stimulation: review of the state of the art (2019) · cites this paper as [39]
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“Numerous series also have reported the efficacy of PNS; however, these involved surgical implantation where the risk of perineural scarring is greater.(14,19,20) PNS benefit is thought to stem from interruption of A- and C fiber signaling.”
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BackgroundPeripheral Nerve Stimulation for Pain Peripheral Neuralgia and Complex Regional Pain Syndrome
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“The literature suggests that between 3% and 30% of patients with neuromas experience symptomatic pain (Nelson 1977; Nashold et al. 1982; Atherton et al. 2006).”
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Metadata
- Authors
- Nashold, B. S., Goldner, J. L., Mullen, J. B., & Bright, D. S.
- Venue
- The Journal of Bone & Joint Surgery
- Published
- 1982-01
- Volume
- 64
- Issue
- 1
- Pages
- 1-10
- ISSN
- 0021-9355 (ISSN-L)
- OpenAlex
- W1907072860
- Cited by
- 184
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 5 · 2019: 8 · 2018: 8 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 12 · 2012: 10
- FWCI
- 4.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Bone and Joint Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- peripheral nerve stimulation, chronic pain, peripheral nerve injury, median nerve, ulnar nerve, sciatic nerve, posterior tibial nerve, electrode implantation, analgesia, implant failure
- MeSH terms
- Adult, Aged, Electrodes, Implanted, Electric Stimulation Therapy, Female, Follow-Up Studies, Humans, Male, Median Nerve, Middle Aged, Nerve Block, Intractable Pain, Sciatic Nerve, Ulnar Nerve, Peripheral Nerve Injuries
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