Peripheral Neurostimulation: Indications and Procedures
Indications
The action principle on which the system and the current clinical evidence in the industry are based, combined with the simpleness of applications, makes ACCUSTIM-P an effective tool for treating the following indications:
- Myofascial Pain
- Occipital and Supraorbital Neuralgia
- Chronic Cervicalgia and Cervicobrachialgias
- Cicatricial Pain
- Allodynia Pain
- Post-Herpetic Pain
- Post-operative Pain (Mastectomy, Inguinal hernia...)
- Phantom Limb syndromes
Also ACCUSTIM-P can be used as a diagnostic tool to identify patients who could benefit from permanent nerve stimulation.
The procedure
Peripheral nerves stimulation with ACCUSTIM-P systems is easily applicable to all indications for which it is recommended. The procedures are absolutely mininvasive and can be practiced both in the surgical and outpatient regime. There are not particular contraindications.
Basically, the system consists of a P-LEAD electrode whose length is compatible with the extension of the area to be treated; this one has to be inserted subcutaneously via, through it own introducer needle, so that to reach and cover with its active part the algic area to be treated.
Once the electrode is right positioned, you connect the ACCUSTIM stimulator included in the system and verify the effectiveness of the positioning through paresthesia test occurs. When the patient feels paresthesia sensations in the affected area, proceed to secure fix all system components and start the pre-defined treatment program for that particular indication.
The duration and number of treatments change depending on the chronicity and by the pain degree complained by the patient. Therapy does not cause dependence, therefore the range of variability is wide and can be optimized even during the therapy. In the most favorable cases, remission or decrease in pain is evident from the first treatment, however the effectiveness is evidenced in most cases after several treatments.
Peripheral Neurostimulation with ACCUSTIM-P: Application in a surgical environment
A typical application of Accustim-P systems is the treatment of Post-Erpetic pain through peripheral neurostimulation. In the following video you can see the procedure performed in a surgical environment, where the algic zone is treated by inserting the P-Lead electrode to the para-vertebral area for all interested levels.
Stimulation Parameters
The peripheral stimulation performed with ACCUSTIM-P allows a wide range of treatments: the stimulation ranges are wide and allow to modulate the electric signal from the lowest frequencies (1-2 Hz) to stimulate the motor fibers, up to higher modulations (100-200 Hz) to stimulate sensory nerves. Electric signals are always composed of biphase rectangular pulses to avoid tissue electrolyte damages.
In particular in PNT and PENS treatments, clinical studies show the best benefits using combined treatments in which the algic area is stimulated with mixed signals that involve both motor and sensory fibers. Typically, the stimulation signal is composed of a signal with frequency of about 100 Hz, alternating every 2-3 seconds with a lower signal of 1-2 Hz frequency. Amplitude values should always be set so that the patient feels NON-annoying paresthesia sensations in the treated area.