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NANS 2010 14th Annual Meeting
Neuromodulation Review Symposium for Nurses, Physician Assistants, Allied
Health Care Professionals, and OR Personnel
Device overview and Interactions
Atom Sarkar MD/PhD
Associate Professor
Department of Neurosurgery
Director - Neuro-Oncology
Member - Center for Translational Neuroscience
Director - Nanomedicine Program
Director – Tumor Biology/Nanotechnology and Advanced Therapeutics Lab
University of Arkansas for Medical Science / College of Medicine
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Neolithic burial site of Ensisheim
intra vitam surgical trepanation 7,000 years ago
Motives for prehistoric trepanations are speculative
• Therapeutic: for head injuries, fractures
• Magical/Spirtual: for brain disorders – persistant headaches,
epilepsy, and mental disease
Nature 1997
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Edwin Smith Surgical Papyrus
Brain
“Membrane” enveloping the Brain
“Corrugations” of the Brain
“Fluid” in the Interior of the Head
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… the use of electricity to treat diseases is among the earliest recorded medical
procedures. Physicians in ancient Egypt used jolts from an electric catfish native to
the Nile River, to reduce the pain of arthritis…
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T12- L1 jumped
facet
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Loss of pigmented
dopaminergic
neurons in the pars
compacta of the
substantia nigra.
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Percutaneous Leads
5-Column Array
3-Column Arrays
Penta™ Lead
2-Column Arrays
1-Column Arrays
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Paddle leads
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Butterfly anchor
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Long/cigar anchor
Cinch™ anchor
Swift-Lock™ Anchor
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Non-rechargeable IPGs
Rechargeable IPGs
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SCS Hardware
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Intra-thecal Drug
Delivery Hardware
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DBS Components
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Long bumpy anchor
Titan® anchor
2- & 3-hole anchor
Twist-Lock® anchor
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Bilateral DBS
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SCS Hardware
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Pain Pump Hardware
http://www.google.com/imgres?imgurl=http://www.columbianeurosurgery.org/wp-content/2009/11/n_fb_5.jpg&imgrefurl=http://www.columbianeurosurgery.org/specialties/pain/treatment/neuromodulation/
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MRI Labeling Review
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MRI Labeling
Medtronic
- Medtronic Information for prescribers, 2007-09, page 5
Boston Scientific Neuromodulation
- Boston Scientific Physician Implant Manual, 9055521-003 Rev A, page 9
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http://www.mrisafety.com/safety_article.asp?subject=235
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MRIs can pose
significant risks to
patients with implanted
devices
Physicians should be
aware of patient safety
issues and physician
liability policies related
to MRI examinations
Medtronic Information for prescribers, 2007-09, page 4
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Case presentation - SCS
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Percutaneous Spinal Cord
Stimulator placement for
CRPS/RSD
right
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right
normal lumbar MRI
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T9
Opps!
T12
T9
T12
right
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T10
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