Open AccessRestorative Neurostimulation: A Clinical Guide for Therapy Adoption
Author(s) -
Krishnan Chakravarthy,
David Lee,
Jennifer Tram,
Samir Sheth,
Robert Heros,
Smith Manion,
Vikas Patel,
Kyle Kiesel,
Yousef Ghandour,
Christopher Gilligan
Publication year - 2022
Publication title -
journal of pain research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 49
ISSN - 1178-7090
DOI - 10.2147/jpr.s364081
Subject(s) - neurostimulation , medicine , physical medicine and rehabilitation , clinical trial , neuromodulation , degeneration (medical) , multifidus muscle , physical therapy , low back pain , stimulation , pathology , alternative medicine
In this review, we present a comprehensive clinical approach to restorative neurostimulation, a novel form of stimulation for refractory chronic mechanical low back pain, targeting impaired neuromuscular control and degeneration of the multifidus muscle. We focus on patient identification, technique guidance, and review of the scientific background and clinical evidence. As our understanding of back pain grows, there is clear evidence that impaired neuromuscular control and consequent degeneration of the multifidus muscle contribute to mechanical low back pain development and maintenance. We provide clinical guidance regarding an implantable restorative neurostimulation system that targets impaired neuromuscular control. Supported by results from a randomized, active-sham-controlled clinical trial with long-term follow-up, we provide clinicians with a comprehensive overview and practical clinical guidance for the adoption of this therapy modality.