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A pioneering group of authors describes in this book, for the first time, the state of the art of spinal cord stimulation for chronic critical limb ischemia. This method, a progeny of pacemaking in cardiac rhythm disorders, is a promising, innovative procedure; it presents a modern challenge in treatment of endstage peripheral vascular disease or neuropathic pains. Spinal cord stimulation may have a tremendous future if it further develops to become a standard treatment in special indications.
List of contents
Anatomy, physiology and pharmacology of pain.- Basic neurophysiological mechanisms of pain and pain control.- The endogenous neuromodulatory system.- Some aspects on pathophysiology of pain in clinical angiology.- Spinal cord stimulation for chronic pain.- Spinal cord stimulation in patients: Basic anatomical and neurophysiological mechanisms.- Neuropathic pain and stimulation of the nervous system.- Spinal cord stimulator: Design and function.- Epidural spinal cord stimulation (ESCS): Implantation technique.- Critical limb ischemia.- Definition, epidemiology, and pathophysiology of critical limb ischemia.- Pharmacotherapy of critical limb ischemia.- Limb salvage, vascular procedures versus primary amputation.- Assessment of the microcirculation.- Evaluation of the skin microcirculation by photoplethysmography, laser Doppler velocimetry, and transcutaneous measurements of pO2.- Laser doppler fluxmetry in peripheral vascular disease.- Clinical evaluations.- Transcutaneous oxygen tension in patients with critical limb ischemia treated by spinal cord stimulation.- Vascular disease and spinal cord stimulation.- Laser-Doppler fluxmetry (LDF) in patients treated by spinal cord stimulation (SCS).- Can spinal cord stimulation reduce the amputation rate in patients with critical limb ischemia?.- Clinical studies.- ESES-trial: Evaluation of epidural spinal cord electric stimulation (ESES) in critical limb ischemia - a randomized controlled clinical trial.- Spinal cord stimulation in peripheral vascular disease treatment: Nine-year experience with 241 patients.- Spinal cord stimulation - Multicentral Spanish study.- Spinal cord stimulation (SCS) in patients with inoperable severe lower limb ischemia. A prospective randomized controlled study of tissue loss and limb salvage.-Spinal cord stimulation for ischemic rest pain. The Belgian randomized study.
