Application of electric current to the spine for treatment of a variety of conditions involving innervation from the spinal cord.
Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the threshold of the skin to pain.
A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.
A condition of persistent pain and discomfort in the BACK and the LEG following lumbar surgery, often seen in patients enrolled in pain centers.
Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation.
Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.).
Surgically placed electric conductors through which ELECTRIC STIMULATION is delivered to or electrical activity is recorded from a specific point inside the body.
Persistent pain that is refractory to some or all forms of treatment.
Space between the dura mater and the walls of the vertebral canal.
A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.
Respiratory muscles that arise from the lower border of one rib and insert into the upper border of the adjoining rib, and contract during inspiration or respiration. (From Stedman, 25th ed)
Surgically placed electric conductors through which ELECTRIC STIMULATION of nerve tissue is delivered.
Use of electric potential or currents to elicit biological responses.
A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33)
Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.
The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.
The noninvasive measurement or determination of the partial pressure (tension) of oxygen and/or carbon dioxide locally in the capillaries of a tissue by the application to the skin of a special set of electrodes. These electrodes contain photoelectric sensors capable of picking up the specific wavelengths of radiation emitted by oxygenated versus reduced hemoglobin.
Conditions characterized by pain involving an extremity or other body region, HYPERESTHESIA, and localized autonomic dysfunction following injury to soft tissue or nerve. The pain is usually associated with ERYTHEMA; SKIN TEMPERATURE changes, abnormal sudomotor activity (i.e., changes in sweating due to altered sympathetic innervation) or edema. The degree of pain and other manifestations is out of proportion to that expected from the inciting event. Two subtypes of this condition have been described: type I; (REFLEX SYMPATHETIC DYSTROPHY) and type II; (CAUSALGIA). (From Pain 1995 Oct;63(1):127-33)
The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.
The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
Aching sensation that persists for more than a few months. It may or may not be associated with trauma or disease, and may persist after the initial injury has healed. Its localization, character, and timing are more vague than with acute pain.
The application, via IMPLANTED ELECTRODES, of short bursts of electrical energy in the radiofrequency range, interspersed with pauses in delivery of the current long enough to dissipate the generated heat and avoid heat-induced tissue necrosis.
A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region.
A pharmacologic congener of serotonin that contracts smooth muscle and has actions similar to those of tricyclic antidepressants. It has been proposed as an oxytocic.
A condition characterized by abnormal posturing of the limbs that is associated with injury to the brainstem. This may occur as a clinical manifestation or induced experimentally in animals. The extensor reflexes are exaggerated leading to rigid extension of the limbs accompanied by hyperreflexia and opisthotonus. This condition is usually caused by lesions which occur in the region of the brainstem that lies between the red nuclei and the vestibular nuclei. In contrast, decorticate rigidity is characterized by flexion of the elbows and wrists with extension of the legs and feet. The causative lesion for this condition is located above the red nuclei and usually consists of diffuse cerebral damage. (From Adams et al., Principles of Neurology, 6th ed, p358)
Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord.
Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.
Electric conductors through which electric currents enter or leave a medium, whether it be an electrolytic solution, solid, molten mass, gas, or vacuum.
These include the muscles of the DIAPHRAGM and the INTERCOSTAL MUSCLES.
The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM.
A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Acute and chronic conditions characterized by external mechanical compression of the SPINAL CORD due to extramedullary neoplasm; EPIDURAL ABSCESS; SPINAL FRACTURES; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence.
An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.
The inferior part of the lower extremity between the KNEE and the ANKLE.
Benign and malignant neoplasms which occur within the substance of the spinal cord (intramedullary neoplasms) or in the space between the dura and spinal cord (intradural extramedullary neoplasms). The majority of intramedullary spinal tumors are primary CNS neoplasms including ASTROCYTOMA; EPENDYMOMA; and LIPOMA. Intramedullary neoplasms are often associated with SYRINGOMYELIA. The most frequent histologic types of intradural-extramedullary tumors are MENINGIOMA and NEUROFIBROMA.
Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms.
Acute or chronic pain located in the posterior regions of the THORAX; LUMBOSACRAL REGION; or the adjacent regions.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.
The position or attitude of the body.
Elements of limited time intervals, contributing to particular results or situations.
Introduction of therapeutic agents into the spinal region using a needle and syringe.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
The flow of BLOOD through or around an organ or region of the body.
The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system.
Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness.
Paired bundles of NERVE FIBERS entering and leaving the SPINAL CORD at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots are efferent, comprising the axons of spinal motor and PREGANGLIONIC AUTONOMIC FIBERS.
Neurons which activate MUSCLE CELLS.
The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Repair of the damaged neuron function after SPINAL CORD INJURY or SPINAL CORD DISEASES.
Act of eliciting a response from a person or organism through physical contact.
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.
The cavity within the SPINAL COLUMN through which the SPINAL CORD passes.
Severe or complete loss of motor function in all four limbs which may result from BRAIN DISEASES; SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or rarely MUSCULAR DISEASES. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper BRAIN STEM which injures the descending cortico-spinal and cortico-bulbar tracts.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Spinal neoplasms are abnormal growths or tumors that develop within the spinal column, which can be benign or malignant, and originate from cells within the spinal structure or spread to the spine from other parts of the body (metastatic).
Procedure in which an anesthetic is injected directly into the spinal cord.
Neurons in the SPINAL CORD DORSAL HORN whose cell bodies and processes are confined entirely to the CENTRAL NERVOUS SYSTEM. They receive collateral or direct terminations of dorsal root fibers. They send their axons either directly to ANTERIOR HORN CELLS or to the WHITE MATTER ascending and descending longitudinal fibers.

Spinal cord stimulation protects against atrial fibrillation induced by tachypacing. (1/28)

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Movement- and behavioral state-dependent activity of pontine reticulospinal neurons. (2/28)

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Cervical spinal cord stimulation with 5-column paddle lead in Raynaud's disease. (3/28)

OBJECTIVE: To report a case of Raynaud disease and its successful treatment with spinal cord stimulation utilizing the newly designed five-column Penta lead paddle. Specific electrode design, programming characteristics, and surgical technique are also discussed in this case. DESIGN: Case Report. SETTING: University pain management center. BACKGROUND: A 65-year-old man with Raynaud disease presented with neck and upper extremity pain. The patient also had herniation and spondylosis of the lumbar spine and intervertebral disc disease of the cervical spine. An examination revealed venous changes, chronic ulceration, and digit discoloration in upper and lower extremities. METHOD: Conservative management and pharmacological treatment were ineffective. Sympathetic block produced significant but limited improvement. Treatment with spinal cord stimulation was tried after a successful 7-day trial. RESULTS: Initial stimulation of the cervical spine with two octapolar leads at the C2 level produced greater than 75% pain improvement. However, the patient lost coverage shortly after discharge due to lead migration which could not be regained with reprogramming. A revision with Penta lead paddles produced sustainable and significant paresthesia coverage. LIMITATIONS: A case report. CONCLUSION: We report the successful application of spinal cord stimulation utilizing a five-column paddle lead in an individual with severe refractory Raynaud disease.  (+info)

Spinal cord stimulation for the treatment of abnormal posture and gait disorder in patients with Parkinson's disease. (4/28)

Patients with advanced Parkinson's disease (PD) often present with axial symptoms, including abnormal posture, postural instability, and gait disorder. Although spinal cord stimulation (SCS) is effective for pain, little is known about the effect of SCS on motor function in PD patients. The present study investigated the effect of SCS on posture and gait in 15 PD patients, 5 men and 10 women aged 63-79 years (mean 71.1 years), with low back pain and leg pain who received SCS. A visual analog scale (VAS) was used for pain evaluation pre- and postoperatively. The Unified Parkinson's Disease Rating Scale, Timed Up and Go tests, and Timed 10-Meter Walk tests were used to evaluate motor function and activities of daily living of patients. Preoperative mean VAS score was 8.9 (range 7.8-10), which showed significant postoperative improvement at 3 months to mean VAS score of 2.0 (range 0-3.3). The improvements in VAS scores persisted at 12 months after surgery with mean VAS score of 2.3 (range 0-4). Posture and postural stability motor subscores were improved at 3 months after SCS, and gait had significantly improved at 3 months and 1 year after surgery. Timed 10-Meter Walk tests also demonstrated that patient gait was significantly improved at 3 months and 12 months after surgery. Most advanced stage PD patients suffer considerable pain that causes abnormal posture and gait disturbance. SCS is expected to lead to both amelioration of pain and improvement of motor function in such patients.  (+info)

Spinal cord stimulation for treatment of patients in the minimally conscious state. (5/28)

Minimally conscious state (MCS) is characterized by inconsistent but clearly discernible behavioral evidence of consciousness, and can be distinguished from coma and the vegetative state (VS). Ten MCS patients were evaluated neurologically and electrophysiologically over 3 months after the onset of brain injury, and were treated by spinal cord stimulation (SCS). A flexible four-contact, cylinder electrode was inserted into the epidural space of the cervical vertebrae, and placed at the C2-C4 levels. Stimulation was applied for 5 minutes every 30 minutes during the daytime at an intensity that produced motor twitches of the upper extremities. We used 5 Hz for SCS, considering that the induced muscle twitches can be a useful functional neurorehabilitation for MCS patients. Eight of the 10 MCS patients satisfied the electrophysiological inclusion criteria, which we proposed on the basis of the results of deep brain stimulation for the treatment of patients in the VS. Seven patients recovered from MCS following SCS therapy, and were able to carry out functional interactive communication and/or demonstrate the functional use of two different objects. Cervical SCS increased cerebral blood flow (CBF) diffusely in the brain, and CBF increased by 22.2% during the stimulation period compared with CBF before stimulation in MCS patients (p < 0.0001, paired t-test). Five-Hz cervical SCS could increase CBF and induce muscle twitches of the upper extremities. This SCS therapy method may be suitable for treating MCS.  (+info)

Pain relief and quality-of-life improvement after spinal cord stimulation in painful diabetic polyneuropathy: a pilot study. (6/28)

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Duration of intra-operative stimulation as a predictor of success of spinal cord stimulation for chronic pain syndromes. (7/28)

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Spinal cord stimulation for chronic pain originating from Lyme disease. (8/28)

BACKGROUND: Neuropathic pain is a relatively common outcome of Lyme disease. Pain management options for these patients have been limited to pharmaceutical treatments. OBJECTIVE: We present a case of chronic pain following Lyme disease treated successfully using spinal cord stimulation (SCS). STUDY DESIGN: Case report. SETTING: Pain management clinic. METHODS: A 62-year-old patient presented with a 5-year history of bilateral foot pain following Lyme disease that failed to respond to medication and physical therapy. The patient was treated by a trial of SCS at the clinic and then implanted with a spinal cord stimulator. The Visual Analog Scale (VAS) assessed pain before and after SCS. RESULTS: The patient reported significant pain relief and improved foot function. The 10 point VAS score was reduced from 8-10 to 1-3. LIMITATIONS: Single case report. CONCLUSION: Spinal cord stimulation may be an effective option for relieving chronic pain originating from Lyme disease.  (+info)

Spinal cord stimulation (SCS) is a medical procedure that involves the use of an implanted device to deliver electrical pulses to the spinal cord. The pulses are intended to interrupt or mask the transmission of pain signals to the brain, thereby reducing the perception of pain. SCS is typically offered as a treatment option for patients with chronic pain who have not found relief from other therapies, such as medication or surgery.

During the procedure, electrodes are placed in the epidural space of the spinal cord, and connected to a pulse generator that is implanted under the skin, usually in the abdomen or buttocks. The patient can use a remote control to adjust the intensity and location of the stimulation, allowing them to customize the therapy to their individual pain patterns.

SCS is generally considered safe, although there are some risks associated with the procedure, such as infection, bleeding, and nerve damage. It is important for patients to discuss these risks with their healthcare provider before deciding whether to undergo SCS.

Electric stimulation therapy, also known as neuromuscular electrical stimulation (NMES) or electromyostimulation, is a therapeutic treatment that uses electrical impulses to stimulate muscles and nerves. The electrical signals are delivered through electrodes placed on the skin near the target muscle group or nerve.

The therapy can be used for various purposes, including:

1. Pain management: Electric stimulation can help reduce pain by stimulating the release of endorphins, which are natural painkillers produced by the body. It can also help block the transmission of pain signals to the brain.
2. Muscle rehabilitation: NMES can be used to prevent muscle atrophy and maintain muscle tone in individuals who are unable to move their muscles due to injury or illness, such as spinal cord injuries or stroke.
3. Improving circulation: Electric stimulation can help improve blood flow and reduce swelling by contracting the muscles and promoting the movement of fluids in the body.
4. Wound healing: NMES can be used to promote wound healing by increasing blood flow, reducing swelling, and improving muscle function around the wound site.
5. Muscle strengthening: Electric stimulation can be used to strengthen muscles by causing them to contract and relax repeatedly, which can help improve muscle strength and endurance.

It is important to note that electric stimulation therapy should only be administered under the guidance of a trained healthcare professional, as improper use can cause harm or discomfort.

The spinal cord is a major part of the nervous system, extending from the brainstem and continuing down to the lower back. It is a slender, tubular bundle of nerve fibers (axons) and support cells (glial cells) that carries signals between the brain and the rest of the body. The spinal cord primarily serves as a conduit for motor information, which travels from the brain to the muscles, and sensory information, which travels from the body to the brain. It also contains neurons that can independently process and respond to information within the spinal cord without direct input from the brain.

The spinal cord is protected by the bony vertebral column (spine) and is divided into 31 segments: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. Each segment corresponds to a specific region of the body and gives rise to pairs of spinal nerves that exit through the intervertebral foramina at each level.

The spinal cord is responsible for several vital functions, including:

1. Reflexes: Simple reflex actions, such as the withdrawal reflex when touching a hot surface, are mediated by the spinal cord without involving the brain.
2. Muscle control: The spinal cord carries motor signals from the brain to the muscles, enabling voluntary movement and muscle tone regulation.
3. Sensory perception: The spinal cord transmits sensory information, such as touch, temperature, pain, and vibration, from the body to the brain for processing and awareness.
4. Autonomic functions: The sympathetic and parasympathetic divisions of the autonomic nervous system originate in the thoracolumbar and sacral regions of the spinal cord, respectively, controlling involuntary physiological responses like heart rate, blood pressure, digestion, and respiration.

Damage to the spinal cord can result in various degrees of paralysis or loss of sensation below the level of injury, depending on the severity and location of the damage.

Failed Back Surgery Syndrome (FBSS) is not a formally recognized medical diagnosis, but rather a term that is used to describe the condition of patients who continue to experience chronic pain in the spine or legs after having undergone one or more spinal surgeries. FBSS does not necessarily mean that the surgery was performed incorrectly, but rather that it did not achieve the desired outcome of relieving the patient's pain.

The symptoms of FBSS can vary from person to person, but often include chronic pain in the back or legs, numbness or tingling sensations, muscle weakness, and decreased mobility. The exact cause of FBSS is not always clear, but it may be due to a variety of factors, such as nerve damage, scar tissue formation, or continued spinal instability.

Treatment for FBSS typically involves a multidisciplinary approach that may include medication, physical therapy, injections, and psychological support. In some cases, additional surgery may be recommended, but this is usually considered a last resort due to the risks involved and the fact that previous surgeries have not been successful.

Paresthesia is a medical term that describes an abnormal sensation such as tingling, numbness, prickling, or burning, usually in the hands, feet, arms, or legs. These sensations can occur without any obvious cause, often described as "pins and needles" or falling asleep in a limb. However, persistent paresthesia can be a sign of an underlying medical condition, such as nerve damage, diabetes, multiple sclerosis, or a vitamin deficiency. It is important to consult with a healthcare professional if experiencing persistent paresthesia to determine the cause and appropriate treatment.

Spinal cord injuries (SCI) refer to damage to the spinal cord that results in a loss of function, such as mobility or feeling. This injury can be caused by direct trauma to the spine or by indirect damage resulting from disease or degeneration of surrounding bones, tissues, or blood vessels. The location and severity of the injury on the spinal cord will determine which parts of the body are affected and to what extent.

The effects of SCI can range from mild sensory changes to severe paralysis, including loss of motor function, autonomic dysfunction, and possible changes in sensation, strength, and reflexes below the level of injury. These injuries are typically classified as complete or incomplete, depending on whether there is any remaining function below the level of injury.

Immediate medical attention is crucial for spinal cord injuries to prevent further damage and improve the chances of recovery. Treatment usually involves immobilization of the spine, medications to reduce swelling and pressure, surgery to stabilize the spine, and rehabilitation to help regain lost function. Despite advances in treatment, SCI can have a significant impact on a person's quality of life and ability to perform daily activities.

Implanted electrodes are medical devices that are surgically placed inside the body to interface directly with nerves, neurons, or other electrically excitable tissue for various therapeutic purposes. These electrodes can be used to stimulate or record electrical activity from specific areas of the body, depending on their design and application.

There are several types of implanted electrodes, including:

1. Deep Brain Stimulation (DBS) electrodes: These are placed deep within the brain to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia. DBS electrodes deliver electrical impulses that modulate abnormal neural activity in targeted brain regions.
2. Spinal Cord Stimulation (SCS) electrodes: These are implanted along the spinal cord to treat chronic pain syndromes. SCS electrodes emit low-level electrical pulses that interfere with pain signals traveling to the brain, providing relief for patients.
3. Cochlear Implant electrodes: These are surgically inserted into the cochlea of the inner ear to restore hearing in individuals with severe to profound hearing loss. The electrodes stimulate the auditory nerve directly, bypassing damaged hair cells within the cochlea.
4. Retinal Implant electrodes: These are implanted in the retina to treat certain forms of blindness caused by degenerative eye diseases like retinitis pigmentosa. The electrodes convert visual information from a camera into electrical signals, which stimulate remaining retinal cells and transmit the information to the brain via the optic nerve.
5. Sacral Nerve Stimulation (SNS) electrodes: These are placed near the sacral nerves in the lower back to treat urinary or fecal incontinence and overactive bladder syndrome. SNS electrodes deliver electrical impulses that regulate the function of the affected muscles and nerves.
6. Vagus Nerve Stimulation (VNS) electrodes: These are wrapped around the vagus nerve in the neck to treat epilepsy and depression. VNS electrodes provide intermittent electrical stimulation to the vagus nerve, which has connections to various regions of the brain involved in these conditions.

Overall, implanted electrodes serve as a crucial component in many neuromodulation therapies, offering an effective treatment option for numerous neurological and sensory disorders.

In medicine, "intractable pain" is a term used to describe pain that is difficult to manage, control or relieve with standard treatments. It's a type of chronic pain that continues for an extended period, often months or even years, and does not respond to conventional therapies such as medications, physical therapy, or surgery. Intractable pain can significantly affect a person's quality of life, causing emotional distress, sleep disturbances, and reduced mobility. It is essential to distinguish intractable pain from acute pain, which is typically sharp and short-lived, resulting from tissue damage or inflammation.

Intractable pain may be classified as:

1. Refractory pain: Pain that persists despite optimal treatment with various modalities, including medications, interventions, and multidisciplinary care.
2. Incurable pain: Pain caused by a progressive or incurable disease, such as cancer, for which no curative treatment is available.
3. Functional pain: Pain without an identifiable organic cause that does not respond to standard treatments.

Managing intractable pain often requires a multidisciplinary approach involving healthcare professionals from various fields, including pain specialists, neurologists, psychiatrists, psychologists, and physical therapists. Treatment options may include:

1. Adjuvant medications: Medications that are not primarily analgesics but have been found to help with pain relief, such as antidepressants, anticonvulsants, and muscle relaxants.
2. Interventional procedures: Minimally invasive techniques like nerve blocks, spinal cord stimulation, or intrathecal drug delivery systems that target specific nerves or areas of the body to reduce pain signals.
3. Psychological interventions: Techniques such as cognitive-behavioral therapy (CBT), mindfulness meditation, and relaxation training can help patients cope with chronic pain and improve their overall well-being.
4. Physical therapy and rehabilitation: Exercise programs, massage, acupuncture, and other physical therapies may provide relief for some types of intractable pain.
5. Complementary and alternative medicine (CAM): Techniques like yoga, tai chi, hypnosis, or biofeedback can be helpful in managing chronic pain.
6. Lifestyle modifications: Dietary changes, stress management, and quitting smoking may also contribute to improved pain management.

The epidural space is the potential space located outside the dura mater, which is the outermost of the three membranes covering the brain and spinal cord (the meninges). This space runs the entire length of the spinal canal and contains fatty tissue, blood vessels, and nerve roots. It is often used as a route for administering anesthesia during childbirth or surgery, as well as for pain management in certain medical conditions. The injection of medications into this space is called an epidural block.

Pain management is a branch of medicine that focuses on the diagnosis and treatment of pain and improvement in the quality of life of patients with chronic pain. The goal of pain management is to reduce pain levels, improve physical functioning, and help patients cope mentally and emotionally with their pain. This may involve the use of medications, interventional procedures, physical therapy, psychological therapy, or a combination of these approaches.

The definition of pain management can vary depending on the medical context, but it generally refers to a multidisciplinary approach that addresses the complex interactions between biological, psychological, and social factors that contribute to the experience of pain. Pain management specialists may include physicians, nurses, physical therapists, psychologists, and other healthcare professionals who work together to provide comprehensive care for patients with chronic pain.

The intercostal muscles are a group of muscles located between the ribs (intercostal spaces) in the thoracic region of the body. They play a crucial role in the process of breathing by assisting in the expansion and contraction of the chest wall during inspiration and expiration.

There are two sets of intercostal muscles: the external intercostals and the internal intercostals. The external intercostals run from the lower edge of one rib to the upper edge of the next lower rib, forming a layer that extends from the tubercles of the ribs down to the costochondral junctions (where the rib meets the cartilage). These muscles help elevate the ribcage during inspiration.

The internal intercostals are deeper and run in the opposite direction, originating at the lower edge of a rib and inserting into the upper edge of the next higher rib. They assist in lowering the ribcage during expiration.

Additionally, there is a third layer called the innermost intercostal muscles, which are even deeper than the internal intercostals and have similar functions. The intercostal membranes connect the ends of the ribs and complete the muscle layers between the ribs. Together, these muscles help maintain the structural integrity of the chest wall and contribute to respiratory function.

An implantable neurostimulator is a type of medical device that is surgically placed inside the body to deliver electrical stimulation to specific nerves or areas of the brain. This can be used to treat a variety of neurological conditions, such as chronic pain, epilepsy, Parkinson's disease, and essential tremor.

The device typically consists of one or more electrodes that are implanted near the target nerve or brain region, connected to a pulse generator that is implanted under the skin, usually in the chest or abdomen. The patient or healthcare provider can program the pulse generator to deliver electrical stimulation at specific times and intensities, which can help to modulate the activity of the targeted nerves and alleviate symptoms.

Implantable neurostimulators are typically considered when other treatments have failed or are not well-tolerated. While they are generally safe and effective, there are some risks associated with surgery and long-term use, such as infection, device malfunction, and discomfort at the implantation site. Therefore, careful consideration and discussion with a healthcare provider is necessary before deciding to proceed with this type of treatment.

Electric stimulation, also known as electrical nerve stimulation or neuromuscular electrical stimulation, is a therapeutic treatment that uses low-voltage electrical currents to stimulate nerves and muscles. It is often used to help manage pain, promote healing, and improve muscle strength and mobility. The electrical impulses can be delivered through electrodes placed on the skin or directly implanted into the body.

In a medical context, electric stimulation may be used for various purposes such as:

1. Pain management: Electric stimulation can help to block pain signals from reaching the brain and promote the release of endorphins, which are natural painkillers produced by the body.
2. Muscle rehabilitation: Electric stimulation can help to strengthen muscles that have become weak due to injury, illness, or surgery. It can also help to prevent muscle atrophy and improve range of motion.
3. Wound healing: Electric stimulation can promote tissue growth and help to speed up the healing process in wounds, ulcers, and other types of injuries.
4. Urinary incontinence: Electric stimulation can be used to strengthen the muscles that control urination and reduce symptoms of urinary incontinence.
5. Migraine prevention: Electric stimulation can be used as a preventive treatment for migraines by applying electrical impulses to specific nerves in the head and neck.

It is important to note that electric stimulation should only be administered under the guidance of a qualified healthcare professional, as improper use can cause harm or discomfort.

Reflex Sympathetic Dystrophy (RSD), also known as Complex Regional Pain Syndrome (CRPS), is a chronic pain condition that most often affects a limb after an injury or trauma. It is characterized by prolonged or excessive pain and sensitivity, along with changes in skin color, temperature, and swelling.

The symptoms of RSD/CRPS are thought to be caused by an overactive sympathetic nervous system, which controls involuntary bodily functions such as heart rate, blood pressure, and sweating. In RSD/CRPS, the sympathetic nerves are believed to send incorrect signals to the brain, causing it to perceive intense pain even in the absence of any actual tissue damage.

RSD/CRPS can be classified into two types: Type 1, which occurs after an injury or trauma that did not directly damage the nerves, and Type 2, which occurs after a distinct nerve injury. The symptoms of both types are similar, but Type 2 is typically more severe and may involve more widespread nerve damage.

Treatment for RSD/CRPS usually involves a combination of medications, physical therapy, and other therapies such as spinal cord stimulation or sympathetic nerve blocks. Early diagnosis and treatment can help improve outcomes and reduce the risk of long-term complications.

Neuralgia is a type of pain that occurs along the pathway of a nerve, often caused by damage or irritation to the nerve. It is typically described as a sharp, stabbing, burning, or electric-shock like pain that can be severe and debilitating. Neuralgia can affect any nerve in the body, but it most commonly occurs in the facial area (trigeminal neuralgia) or in the nerves related to the spine (postherpetic neuralgia). The pain associated with neuralgia can be intermittent or constant and may be worsened by certain triggers such as touch, temperature changes, or movement. Treatment for neuralgia typically involves medications to manage pain, as well as other therapies such as nerve blocks, surgery, or lifestyle modifications.

Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive method of pain relief that involves the use of low-voltage electrical currents. A TENS device, which is usually small and portable, delivers these currents through electrodes that are placed on the skin near the site of pain. The electrical impulses stimulate nerve fibers, which can help to block the transmission of pain signals to the brain, thereby reducing the perception of pain.

TENS is thought to work through a number of different mechanisms, including the gate control theory of pain and the release of endorphins, which are natural painkillers produced by the body. It is generally considered safe, with few side effects, and can be used in conjunction with other forms of pain management.

TENS is often used to treat chronic pain conditions such as arthritis, fibromyalgia, and lower back pain, as well as acute pain from injuries or surgery. However, its effectiveness varies from person to person, and it may not work for everyone. It is important to consult with a healthcare provider before using TENS, particularly if you have any underlying medical conditions or are taking medication that could interact with the electrical currents.

Transcutaneous blood gas monitoring (TcBGM) is a non-invasive method to measure the partial pressure of oxygen (pO2) and carbon dioxide (pCO2) in the blood. This technique uses heated sensors placed on the skin, typically on the ear lobe or the soles of the feet, to estimate the gas tensions in the capillary blood.

The sensors contain a electrochemical or optical sensor that measures the pO2 and pCO2 levels in the tiny amount of gas that diffuses through the skin from the underlying capillaries. The measurements are then adjusted to reflect the actual blood gas values based on calibration curves and other factors, such as the patient's age, temperature, and skin perfusion.

TcBGM is commonly used in neonatal intensive care units (NICUs) to monitor oxygenation and ventilation in premature infants, who may have immature lungs or other respiratory problems that make invasive blood gas sampling difficult or risky. It can also be used in adults with conditions such as chronic obstructive pulmonary disease (COPD), sleep apnea, or neuromuscular disorders, where frequent blood gas measurements are needed to guide therapy and monitor response to treatment.

Overall, TcBGM provides a safe, painless, and convenient way to monitor blood gases in real-time, without the need for repeated arterial punctures or other invasive procedures. However, it is important to note that TcBGM may not always provide accurate measurements in certain situations, such as when the skin perfusion is poor or when there are significant differences between the capillary and arterial blood gases. Therefore, clinical judgment and other diagnostic tests should be used in conjunction with TcBGM to ensure appropriate patient management.

Complex Regional Pain Syndromes (CRPS) are a group of chronic pain conditions that typically affect a limb after an injury or trauma. They are characterized by prolonged, severe and often debilitating pain that is out of proportion to the severity of the initial injury. CRPS is divided into two types:

1. CRPS-1 (also known as Reflex Sympathetic Dystrophy): This type occurs without a clearly defined nerve injury. It usually develops after an illness or injury that didn't directly damage the nerves.
2. CRPS-2 (also known as Causalgia): This type is associated with a confirmed nerve injury.

The symptoms of CRPS include:

* Continuous, burning or throbbing pain in the affected limb
* Changes in skin temperature, color and texture
* Swelling and stiffness in the joints
* Decreased range of motion and weakness in the affected limb
* Sensitivity to touch or cold
* Abnormal sweating pattern in the affected area
* Changes in nail and hair growth patterns

The exact cause of CRPS is not fully understood, but it is thought to be related to a dysfunction in the nervous system's response to injury. Treatment for CRPS typically involves a combination of medications, physical therapy, and psychological support. In some cases, more invasive treatments such as nerve blocks or spinal cord stimulation may be recommended.

The cervical vertebrae are the seven vertebrae that make up the upper part of the spine, also known as the neck region. They are labeled C1 to C7, with C1 being closest to the skull and C7 connecting to the thoracic vertebrae in the chest region. The cervical vertebrae have unique structures to allow for a wide range of motion in the neck while also protecting the spinal cord and providing attachment points for muscles and ligaments.

Angina pectoris is a medical term that describes chest pain or discomfort caused by an inadequate supply of oxygen-rich blood to the heart muscle. This condition often occurs due to coronary artery disease, where the coronary arteries become narrowed or blocked by the buildup of cholesterol, fatty deposits, and other substances, known as plaques. These blockages can reduce blood flow to the heart, causing ischemia (lack of oxygen) and leading to angina symptoms.

There are two primary types of angina: stable and unstable. Stable angina is predictable and usually occurs during physical exertion or emotional stress when the heart needs more oxygen-rich blood. The pain typically subsides with rest or after taking prescribed nitroglycerin medication, which helps widen the blood vessels and improve blood flow to the heart.

Unstable angina, on the other hand, is more severe and unpredictable. It can occur at rest, during sleep, or with minimal physical activity and may not be relieved by rest or nitroglycerin. Unstable angina is considered a medical emergency, as it could indicate an imminent heart attack.

Symptoms of angina pectoris include chest pain, pressure, tightness, or heaviness that typically radiates to the left arm, neck, jaw, or back. Shortness of breath, nausea, sweating, and fatigue may also accompany angina symptoms. Immediate medical attention is necessary if you experience chest pain or discomfort, especially if it's new, severe, or persistent, as it could be a sign of a more serious condition like a heart attack.

Chronic pain is defined as pain that persists or recurs for a period of 3 months or longer, beyond the normal healing time for an injury or illness. It can be continuous or intermittent and range from mild to severe. Chronic pain can have various causes, such as nerve damage, musculoskeletal conditions, or chronic diseases like cancer. It can significantly impact a person's quality of life, causing limitations in mobility, sleep disturbances, mood changes, and decreased overall well-being. Effective management of chronic pain often involves a multidisciplinary approach, including medications, physical therapy, psychological interventions, and complementary therapies.

Pulsed radiofrequency (PRF) treatment is a minimally invasive therapeutic procedure used in pain management and interventional medicine. It involves the use of electrical pulses, delivered via a specialized needle-like probe, to target specific nerves or nerve roots. These electrical pulses are delivered in a controlled and precise manner, at a frequency that does not cause heat damage to the surrounding tissues.

The goal of PRF treatment is to modulate the transmission of pain signals from the affected area to the brain, thereby reducing the perception of pain. The exact mechanism by which PRF works is not fully understood, but it is thought to involve changes in the electrical properties of nerve cells and the release of various chemical mediators that influence pain processing.

PRF treatment is typically performed under local anesthesia or conscious sedation, depending on the patient's preference and the specific procedure being performed. It is generally considered a safe and well-tolerated procedure, with few reported side effects. However, as with any medical intervention, there are potential risks and benefits that should be discussed with a qualified healthcare provider before undergoing treatment.

The thoracic vertebrae are the 12 vertebrae in the thoracic region of the spine, which is the portion between the cervical and lumbar regions. These vertebrae are numbered T1 to T12, with T1 being closest to the skull and T12 connecting to the lumbar region.

The main function of the thoracic vertebrae is to provide stability and support for the chest region, including protection for the vital organs within, such as the heart and lungs. Each thoracic vertebra has costal facets on its sides, which articulate with the heads of the ribs, forming the costovertebral joints. This connection between the spine and the ribcage allows for a range of movements while maintaining stability.

The thoracic vertebrae have a unique structure compared to other regions of the spine. They are characterized by having long, narrow bodies, small bony processes, and prominent spinous processes that point downwards. This particular shape and orientation of the thoracic vertebrae contribute to their role in limiting excessive spinal movement and providing overall trunk stability.

Quipazine is not generally considered a medical term, but it is a chemical compound that has been studied in the field of medicine and neuroscience. Quipazine is a type of drug known as a serotonin receptor agonist, which means it binds to and activates serotonin receptors in the brain.

Serotonin is a neurotransmitter, a chemical that transmits signals in the brain and nervous system, that plays a role in regulating mood, appetite, sleep, and other functions. Quipazine has been studied for its potential therapeutic uses in various conditions, including depression, anxiety, schizophrenia, and substance abuse disorders. However, it is not currently approved for use as a medication in any country.

It's important to note that while quipazine may have potential therapeutic benefits, it also has significant side effects, including seizures, changes in heart rate and blood pressure, and neuroleptic malignant syndrome, a potentially life-threatening condition characterized by muscle rigidity, fever, and autonomic dysfunction. As such, its use is generally limited to research settings.

A decerebrate state is a medical condition that results from severe damage to the brainstem, specifically to the midbrain and above. This type of injury can cause motor responses characterized by rigid extension of the arms and legs, with the arms rotated outward and the wrists and fingers extended. The legs are also extended and the toes pointed downward. These postures are often referred to as "decerebrate rigidity" or "posturing."

The decerebrate state is typically seen in patients who have experienced severe trauma, such as a car accident or gunshot wound, or who have suffered from a large stroke or other type of brain hemorrhage. It can also occur in some cases of severe hypoxia (lack of oxygen) to the brain, such as during cardiac arrest or drowning.

The decerebrate state is a serious medical emergency that requires immediate treatment. If left untreated, it can lead to further brain damage and even death. Treatment typically involves providing supportive care, such as mechanical ventilation to help with breathing, medications to control blood pressure and prevent seizures, and surgery to repair any underlying injuries or bleeding. In some cases, patients may require long-term rehabilitation to regain lost function and improve their quality of life.

Spinal cord diseases refer to a group of conditions that affect the spinal cord, which is a part of the central nervous system responsible for transmitting messages between the brain and the rest of the body. These diseases can cause damage to the spinal cord, leading to various symptoms such as muscle weakness, numbness, pain, bladder and bowel dysfunction, and difficulty with movement and coordination.

Spinal cord diseases can be congenital or acquired, and they can result from a variety of causes, including infections, injuries, tumors, degenerative conditions, autoimmune disorders, and genetic factors. Some examples of spinal cord diseases include multiple sclerosis, spina bifida, spinal cord injury, herniated discs, spinal stenosis, and motor neuron diseases such as amyotrophic lateral sclerosis (ALS).

The treatment for spinal cord diseases varies depending on the underlying cause and severity of the condition. Treatment options may include medication, physical therapy, surgery, and rehabilitation. In some cases, the damage to the spinal cord may be irreversible, leading to permanent disability or paralysis.

Pain measurement, in a medical context, refers to the quantification or evaluation of the intensity and/or unpleasantness of a patient's subjective pain experience. This is typically accomplished through the use of standardized self-report measures such as numerical rating scales (NRS), visual analog scales (VAS), or categorical scales (mild, moderate, severe). In some cases, physiological measures like heart rate, blood pressure, and facial expressions may also be used to supplement self-reported pain ratings. The goal of pain measurement is to help healthcare providers better understand the nature and severity of a patient's pain in order to develop an effective treatment plan.

An electrode is a medical device that can conduct electrical currents and is used to transmit or receive electrical signals, often in the context of medical procedures or treatments. In a medical setting, electrodes may be used for a variety of purposes, such as:

1. Recording electrical activity in the body: Electrodes can be attached to the skin or inserted into body tissues to measure electrical signals produced by the heart, brain, muscles, or nerves. This information can be used to diagnose medical conditions, monitor the effectiveness of treatments, or guide medical procedures.
2. Stimulating nerve or muscle activity: Electrodes can be used to deliver electrical impulses to nerves or muscles, which can help to restore function or alleviate symptoms in people with certain medical conditions. For example, electrodes may be used to stimulate the nerves that control bladder function in people with spinal cord injuries, or to stimulate muscles in people with muscle weakness or paralysis.
3. Administering treatments: Electrodes can also be used to deliver therapeutic treatments, such as transcranial magnetic stimulation (TMS) for depression or deep brain stimulation (DBS) for movement disorders like Parkinson's disease. In these procedures, electrodes are implanted in specific areas of the brain and connected to a device that generates electrical impulses, which can help to regulate abnormal brain activity and improve symptoms.

Overall, electrodes play an important role in many medical procedures and treatments, allowing healthcare professionals to diagnose and treat a wide range of conditions that affect the body's electrical systems.

Respiratory muscles are a group of muscles involved in the process of breathing. They include the diaphragm, intercostal muscles (located between the ribs), scalene muscles (located in the neck), and abdominal muscles. These muscles work together to allow the chest cavity to expand or contract, which draws air into or pushes it out of the lungs. The diaphragm is the primary muscle responsible for breathing, contracting to increase the volume of the chest cavity and draw air into the lungs during inhalation. The intercostal muscles help to further expand the ribcage, while the abdominal muscles assist in exhaling by compressing the abdomen and pushing up on the diaphragm.

Somatosensory evoked potentials (SEPs) are electrical signals generated in the brain and spinal cord in response to the stimulation of peripheral nerves. These responses are recorded and measured to assess the functioning of the somatosensory system, which is responsible for processing sensations such as touch, temperature, vibration, and proprioception (the sense of the position and movement of body parts).

SEPs are typically elicited by applying electrical stimuli to peripheral nerves in the arms or legs. The resulting neural responses are then recorded using electrodes placed on the scalp or other locations on the body. These recordings can provide valuable information about the integrity and function of the nervous system, and are often used in clinical settings to diagnose and monitor conditions such as nerve damage, spinal cord injury, multiple sclerosis, and other neurological disorders.

SEPs can be further categorized based on the specific type of stimulus used and the location of the recording electrodes. For example, short-latency SEPs (SLSEPs) are those that occur within the first 50 milliseconds after stimulation, and are typically recorded from the scalp over the primary sensory cortex. These responses reflect the earliest stages of sensory processing and can be used to assess the integrity of the peripheral nerves and the ascending sensory pathways in the spinal cord.

In contrast, long-latency SEPs (LLSEPs) occur after 50 milliseconds and are typically recorded from more posterior regions of the scalp over the parietal cortex. These responses reflect later stages of sensory processing and can be used to assess higher-level cognitive functions such as attention, memory, and perception.

Overall, SEPs provide a valuable tool for clinicians and researchers seeking to understand the functioning of the somatosensory system and diagnose or monitor neurological disorders.

Ischemia is the medical term used to describe a lack of blood flow to a part of the body, often due to blocked or narrowed blood vessels. This can lead to a shortage of oxygen and nutrients in the tissues, which can cause them to become damaged or die. Ischemia can affect many different parts of the body, including the heart, brain, legs, and intestines. Symptoms of ischemia depend on the location and severity of the blockage, but they may include pain, cramping, numbness, weakness, or coldness in the affected area. In severe cases, ischemia can lead to tissue death (gangrene) or organ failure. Treatment for ischemia typically involves addressing the underlying cause of the blocked blood flow, such as through medication, surgery, or lifestyle changes.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Spinal cord compression is a medical condition that refers to the narrowing of the spinal canal, which puts pressure on the spinal cord and the nerves that branch out from it. This can occur due to various reasons such as degenerative changes in the spine, herniated discs, bone spurs, tumors, or fractures. The compression can lead to a range of symptoms including pain, numbness, tingling, weakness, or loss of bladder and bowel control. In severe cases, it can cause paralysis. Treatment options depend on the underlying cause and may include physical therapy, medication, surgery, or radiation therapy.

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It is a complex phenomenon that can result from various stimuli, such as thermal, mechanical, or chemical irritation, and it can be acute or chronic. The perception of pain involves the activation of specialized nerve cells called nociceptors, which transmit signals to the brain via the spinal cord. These signals are then processed in different regions of the brain, leading to the conscious experience of pain. It's important to note that pain is a highly individual and subjective experience, and its perception can vary widely among individuals.

In medical terms, the leg refers to the lower portion of the human body that extends from the knee down to the foot. It includes the thigh (femur), lower leg (tibia and fibula), foot, and ankle. The leg is primarily responsible for supporting the body's weight and enabling movements such as standing, walking, running, and jumping.

The leg contains several important structures, including bones, muscles, tendons, ligaments, blood vessels, nerves, and joints. These structures work together to provide stability, support, and mobility to the lower extremity. Common medical conditions that can affect the leg include fractures, sprains, strains, infections, peripheral artery disease, and neurological disorders.

Spinal cord neoplasms refer to abnormal growths or tumors within the spinal cord. These can be benign (non-cancerous) or malignant (cancerous). They originate from the cells within the spinal cord itself (primary tumors), or they may spread to the spinal cord from other parts of the body (metastatic tumors). Spinal cord neoplasms can cause various symptoms depending on their location and size, including back pain, neurological deficits, and even paralysis. Treatment options include surgery, radiation therapy, and chemotherapy.

Locomotion, in a medical context, refers to the ability to move independently and change location. It involves the coordinated movement of the muscles, bones, and nervous system that enables an individual to move from one place to another. This can include walking, running, jumping, or using assistive devices such as wheelchairs or crutches. Locomotion is a fundamental aspect of human mobility and is often assessed in medical evaluations to determine overall health and functioning.

Back pain is a common symptom characterized by discomfort or soreness in the back, often occurring in the lower region of the back (lumbago). It can range from a mild ache to a sharp stabbing or shooting pain, and it may be accompanied by stiffness, restricted mobility, and difficulty performing daily activities. Back pain is typically caused by strain or sprain to the muscles, ligaments, or spinal joints, but it can also result from degenerative conditions, disc herniation, spinal stenosis, osteoarthritis, or other medical issues affecting the spine. The severity and duration of back pain can vary widely, with some cases resolving on their own within a few days or weeks, while others may require medical treatment and rehabilitation.

A chronic disease is a long-term medical condition that often progresses slowly over a period of years and requires ongoing management and care. These diseases are typically not fully curable, but symptoms can be managed to improve quality of life. Common chronic diseases include heart disease, stroke, cancer, diabetes, arthritis, and COPD (chronic obstructive pulmonary disease). They are often associated with advanced age, although they can also affect children and younger adults. Chronic diseases can have significant impacts on individuals' physical, emotional, and social well-being, as well as on healthcare systems and society at large.

Spinal cord ischemia refers to a reduction or interruption of blood flow to the spinal cord, leading to insufficient oxygen and nutrient supply. This condition can cause damage to the spinal cord tissue, potentially resulting in neurological deficits, such as muscle weakness, sensory loss, or autonomic dysfunction. Spinal cord ischemia may be caused by various factors, including atherosclerosis, embolism, spinal artery stenosis, or complications during surgery. The severity and extent of the neurological impairment depend on the duration and location of the ischemic event in the spinal cord.

Posture is the position or alignment of body parts supported by the muscles, especially the spine and head in relation to the vertebral column. It can be described as static (related to a stationary position) or dynamic (related to movement). Good posture involves training your body to stand, walk, sit, and lie in positions where the least strain is placed on supporting muscles and ligaments during movement or weight-bearing activities. Poor posture can lead to various health issues such as back pain, neck pain, headaches, and respiratory problems.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Spinal injections, also known as epidural injections or intrathecal injections, are medical procedures involving the injection of medications directly into the spinal canal. The medication is usually delivered into the space surrounding the spinal cord (the epidural space) or into the cerebrospinal fluid that surrounds and protects the spinal cord (the subarachnoid space).

The medications used in spinal injections can include local anesthetics, steroids, opioids, or a combination of these. The purpose of spinal injections is to provide diagnostic information, therapeutic relief, or both. They are commonly used to treat various conditions affecting the spine, such as radicular pain (pain that radiates down the arms or legs), disc herniation, spinal stenosis, and degenerative disc disease.

Spinal injections can be administered using different techniques, including fluoroscopy-guided injections, computed tomography (CT) scan-guided injections, or with the help of a nerve stimulator. These techniques ensure accurate placement of the medication and minimize the risk of complications.

It is essential to consult a healthcare professional for specific information regarding spinal injections and their potential benefits and risks.

I believe there might be a misunderstanding in your question. "Dogs" is not a medical term or condition. It is the common name for a domesticated carnivore of the family Canidae, specifically the genus Canis, which includes wolves, foxes, and other extant and extinct species of mammals. Dogs are often kept as pets and companions, and they have been bred in a wide variety of forms and sizes for different purposes, such as hunting, herding, guarding, assisting police and military forces, and providing companionship and emotional support.

If you meant to ask about a specific medical condition or term related to dogs, please provide more context so I can give you an accurate answer.

Regional blood flow (RBF) refers to the rate at which blood flows through a specific region or organ in the body, typically expressed in milliliters per minute per 100 grams of tissue (ml/min/100g). It is an essential physiological parameter that reflects the delivery of oxygen and nutrients to tissues while removing waste products. RBF can be affected by various factors such as metabolic demands, neural regulation, hormonal influences, and changes in blood pressure or vascular resistance. Measuring RBF is crucial for understanding organ function, diagnosing diseases, and evaluating the effectiveness of treatments.

The sympathetic nervous system (SNS) is a part of the autonomic nervous system that operates largely below the level of consciousness, and it functions to produce appropriate physiological responses to perceived danger. It's often associated with the "fight or flight" response. The SNS uses nerve impulses to stimulate target organs, causing them to speed up (e.g., increased heart rate), prepare for action, or otherwise respond to stressful situations.

The sympathetic nervous system is activated due to stressful emotional or physical situations and it prepares the body for immediate actions. It dilates the pupils, increases heart rate and blood pressure, accelerates breathing, and slows down digestion. The primary neurotransmitter involved in this system is norepinephrine (also known as noradrenaline).

Paraplegia is a medical condition characterized by partial or complete loss of motor function and sensation in the lower extremities, typically affecting both legs. This results from damage to the spinal cord, often due to trauma such as accidents, falls, or gunshot wounds, or from diseases like spina bifida, polio, or tumors. The specific area and extent of the injury on the spinal cord determine the severity and location of paralysis. Individuals with paraplegia may require assistive devices for mobility, such as wheelchairs, and may face various health challenges, including pressure sores, urinary tract infections, and chronic pain.

Spinal nerve roots are the initial parts of spinal nerves that emerge from the spinal cord through the intervertebral foramen, which are small openings between each vertebra in the spine. These nerve roots carry motor, sensory, and autonomic fibers to and from specific regions of the body. There are 31 pairs of spinal nerve roots in total, with 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal pair. Each root has a dorsal (posterior) and ventral (anterior) ramus that branch off to form the peripheral nervous system. Irritation or compression of these nerve roots can result in pain, numbness, weakness, or loss of reflexes in the affected area.

Motor neurons are specialized nerve cells in the brain and spinal cord that play a crucial role in controlling voluntary muscle movements. They transmit electrical signals from the brain to the muscles, enabling us to perform actions such as walking, talking, and swallowing. There are two types of motor neurons: upper motor neurons, which originate in the brain's motor cortex and travel down to the brainstem and spinal cord; and lower motor neurons, which extend from the brainstem and spinal cord to the muscles. Damage or degeneration of these motor neurons can lead to various neurological disorders, such as amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA).

Spinal nerves are the bundles of nerve fibers that transmit signals between the spinal cord and the rest of the body. There are 31 pairs of spinal nerves in the human body, which can be divided into five regions: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. Each spinal nerve carries both sensory information (such as touch, temperature, and pain) from the periphery to the spinal cord, and motor information (such as muscle control) from the spinal cord to the muscles and other structures in the body. Spinal nerves also contain autonomic fibers that regulate involuntary functions such as heart rate, digestion, and blood pressure.

Myocardial ischemia is a condition in which the blood supply to the heart muscle (myocardium) is reduced or blocked, leading to insufficient oxygen delivery and potential damage to the heart tissue. This reduction in blood flow typically results from the buildup of fatty deposits, called plaques, in the coronary arteries that supply the heart with oxygen-rich blood. The plaques can rupture or become unstable, causing the formation of blood clots that obstruct the artery and limit blood flow.

Myocardial ischemia may manifest as chest pain (angina pectoris), shortness of breath, fatigue, or irregular heartbeats (arrhythmias). In severe cases, it can lead to myocardial infarction (heart attack) if the oxygen supply is significantly reduced or cut off completely, causing permanent damage or death of the heart muscle. Early diagnosis and treatment of myocardial ischemia are crucial for preventing further complications and improving patient outcomes.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

Spinal cord regeneration is the process of regrowth or repair of damaged or severed nerves and neural connections within the spinal cord. This complex process involves various biological mechanisms, including the activation of stem cells, the promotion of axonal growth, and the remodeling of neural circuits. The ultimate goal of spinal cord regeneration research is to develop effective therapies for individuals with spinal cord injuries, enabling them to regain sensory and motor functions and improve their quality of life.

Physical stimulation, in a medical context, refers to the application of external forces or agents to the body or its tissues to elicit a response. This can include various forms of touch, pressure, temperature, vibration, or electrical currents. The purpose of physical stimulation may be therapeutic, as in the case of massage or physical therapy, or diagnostic, as in the use of reflex tests. It is also used in research settings to study physiological responses and mechanisms.

In a broader sense, physical stimulation can also refer to the body's exposure to physical activity or exercise, which can have numerous health benefits, including improving cardiovascular function, increasing muscle strength and flexibility, and reducing the risk of chronic diseases.

Sprague-Dawley rats are a strain of albino laboratory rats that are widely used in scientific research. They were first developed by researchers H.H. Sprague and R.C. Dawley in the early 20th century, and have since become one of the most commonly used rat strains in biomedical research due to their relatively large size, ease of handling, and consistent genetic background.

Sprague-Dawley rats are outbred, which means that they are genetically diverse and do not suffer from the same limitations as inbred strains, which can have reduced fertility and increased susceptibility to certain diseases. They are also characterized by their docile nature and low levels of aggression, making them easier to handle and study than some other rat strains.

These rats are used in a wide variety of research areas, including toxicology, pharmacology, nutrition, cancer, and behavioral studies. Because they are genetically diverse, Sprague-Dawley rats can be used to model a range of human diseases and conditions, making them an important tool in the development of new drugs and therapies.

Cost-benefit analysis (CBA) is a systematic process used to compare the costs and benefits of different options to determine which one provides the greatest net benefit. In a medical context, CBA can be used to evaluate the value of medical interventions, treatments, or policies by estimating and monetizing all the relevant costs and benefits associated with each option.

The costs included in a CBA may include direct costs such as the cost of the intervention or treatment itself, as well as indirect costs such as lost productivity or time away from work. Benefits may include improved health outcomes, reduced morbidity or mortality, and increased quality of life.

Once all the relevant costs and benefits have been identified and quantified, they are typically expressed in monetary terms to allow for a direct comparison. The option with the highest net benefit (i.e., the difference between total benefits and total costs) is considered the most cost-effective.

It's important to note that CBA has some limitations and can be subject to various biases and assumptions, so it should be used in conjunction with other evaluation methods to ensure a comprehensive understanding of the value of medical interventions or policies.

The spinal canal is the bony, protective channel within the vertebral column that contains and houses the spinal cord. It extends from the foramen magnum at the base of the skull to the sacrum, where the spinal cord ends and forms the cauda equina. The spinal canal is formed by a series of vertebral bodies stacked on top of each other, intervertebral discs in between them, and the laminae and spinous processes that form the posterior elements of the vertebrae. The spinal canal provides protection to the spinal cord from external trauma and contains cerebrospinal fluid (CSF) that circulates around the cord, providing nutrients and cushioning. Any narrowing or compression of the spinal canal, known as spinal stenosis, can cause various neurological symptoms due to pressure on the spinal cord or nerve roots.

Quadriplegia, also known as tetraplegia, is a medical condition characterized by paralysis affecting all four limbs and the trunk of the body. It results from damage to the cervical spinal cord, typically at levels C1-C8, which controls signals to the muscles in the arms, hands, trunk, legs, and pelvic organs. The extent of quadriplegia can vary widely, ranging from weakness to complete loss of movement and sensation below the level of injury. Other symptoms may include difficulty breathing, bowel and bladder dysfunction, and sexual dysfunction. The severity and prognosis depend on the location and extent of the spinal cord injury.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

Spinal neoplasms refer to abnormal growths or tumors found within the spinal column, which can be benign (non-cancerous) or malignant (cancerous). These tumors can originate in the spine itself, called primary spinal neoplasms, or they can spread to the spine from other parts of the body, known as secondary or metastatic spinal neoplasms. Spinal neoplasms can cause various symptoms, such as back pain, neurological deficits, and even paralysis, depending on their location and size. Early diagnosis and treatment are crucial to prevent or minimize long-term complications and improve the patient's prognosis.

Spinal anesthesia is a type of regional anesthesia that involves injecting local anesthetic medication into the cerebrospinal fluid in the subarachnoid space, which is the space surrounding the spinal cord. This procedure is typically performed by introducing a needle into the lower back, between the vertebrae, to reach the subarachnoid space.

Once the local anesthetic is introduced into this space, it spreads to block nerve impulses from the corresponding levels of the spine, resulting in numbness and loss of sensation in specific areas of the body below the injection site. The extent and level of anesthesia depend on the amount and type of medication used, as well as the patient's individual response.

Spinal anesthesia is often used for surgeries involving the lower abdomen, pelvis, or lower extremities, such as cesarean sections, hernia repairs, hip replacements, and knee arthroscopies. It can also be utilized for procedures like epidural steroid injections to manage chronic pain conditions affecting the spine and lower limbs.

While spinal anesthesia provides effective pain relief during and after surgery, it may cause side effects such as low blood pressure, headache, or difficulty urinating. These potential complications should be discussed with the healthcare provider before deciding on this type of anesthesia.

Posterior horn cells refer to the neurons located in the posterior (or dorsal) horn of the gray matter in the spinal cord. These cells are primarily responsible for receiving and processing sensory information from peripheral nerves, particularly related to touch, pressure, pain, and temperature. The axons of these cells form the ascending tracts that carry this information to the brain for further processing. It's worth noting that damage to posterior horn cells can result in various sensory deficits, such as those seen in certain neurological conditions.

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