治疗慢性疼痛的电神经调控:植入式脊髓刺激疗法的内在障碍、结果和可持续性考虑因素的推导。

Expert review of medical devices Pub Date : 2024-08-01 Epub Date: 2024-07-23 DOI:10.1080/17434440.2024.2382234
Mark N Malinowski, Brandon E Gish, Alexandra M Moreira, Marcin Karcz, Lucas A Bracero, Timothy R Deer
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引用次数: 0

摘要

介绍:60 多年来,脊髓刺激作为一种疗法,通过创新和新的发展经久不衰。当前的神经调控实践需要正确选择患者、降低风险和利用创新。然而,在生理学、临床科学和社会中存在着有形和无形的挑战:我们对该领域的新课题进行了叙述性讨论,尤其是在过去十年中。我们强调了患者护理环境中的挑战,包括选择以及经济和社会经济方面的挑战。我们探讨了神经调控方面的医生培训挑战,以及与神经调控的使用有关的其他因素,如新适应症和经济学。我们还讨论了技术和医疗数据的概念:患者安全和持久疗效是神经调控的主要目标。我们需要做大量的工作来吸收数据,以进行更大规模、更相关的研究,从而反映人群的情况。大数据和全球互联努力为我们提供了大量机会来重塑我们的科学方法、数据分析及其管理,以最大限度地提高疗效和降低风险。随着数据分析的改进成为创新的标准,医生培训满足需求,我们有望看到新适应症的扩展及其在更广泛人群中的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Electrical neuromodulation for the treatment of chronic pain: derivation of the intrinsic barriers, outcomes and considerations of the sustainability of implantable spinal cord stimulation therapies.

Introduction: For over 60 years, spinal cord stimulation has endured as a therapy through innovation and novel developments. Current practice of neuromodulation requires proper patient selection, risk mitigation and use of innovation. However, there are tangible and intangible challenges in physiology, clinical science and within society.

Areas covered: We provide a narrative discussion regarding novel topics in the field especially over the last decade. We highlight the challenges in the patient care setting including selection, as well as economic and socioeconomic challenges. Physician training challenges in neuromodulation is explored as well as other factors related to the use of neuromodulation such as novel indications and economics. We also discuss the concepts of technology and healthcare data.

Expert opinion: Patient safety and durable outcomes are the mainstay goal for neuromodulation. Substantial work is needed to assimilate data for larger and more relevant studies reflecting a population. Big data and global interconnectivity efforts provide substantial opportunity to reinvent our scientific approach, data analysis and its management to maximize outcomes and minimize risk. As improvements in data analysis become the standard of innovation and physician training meets demand, we expect to see an expansion of novel indications and its use in broader cohorts.

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