Bowman Richard G, Caraway David, Bentley Ishmael
The Center for Pain Relief, Charleston, WV, USA Center for Pain Relief Tristate, Huntington, WV, USA Anulex Technologies, Inc., Minnetonka, MN, USA.
Neuromodulation. 2013 Sep-Oct;16(5):454-8; discussion 458. doi: 10.1111/j.1525-1403.2012.00480.x. Epub 2012 Jul 10.
Spinal cord stimulation is a well-established treatment for chronic neuropathic pain of the trunk or limbs. Currently, the standard method of fixation is to affix the leads of the neuromodulation device to soft tissue, fascia or ligament, through the use of manually tying general suture. A novel semiautomated device is proposed that may be advantageous to the current standard. Comparison testing in an excised caprine spine and simulated bench top model was performed.
Three tests were performed: 1) perpendicular pull from fascia of caprine spine; 2) axial pull from fascia of caprine spine; and 3) axial pull from Mylar film. Six samples of each configuration were tested for each scenario. Standard 2-0 Ethibond was compared with a novel semiautomated device (Anulex fiXate). Upon completion of testing statistical analysis was performed for each scenario.
For perpendicular pull in the caprine spine, the failure load for standard suture was 8.95 lbs with a standard deviation of 1.39 whereas for fiXate the load was 15.93 lbs with a standard deviation of 2.09. For axial pull in the caprine spine, the failure load for standard suture was 6.79 lbs with a standard deviation of 1.55 whereas for fiXate the load was 12.31 lbs with a standard deviation of 4.26. For axial pull in Mylar film, the failure load for standard suture was 10.87 lbs with a standard deviation of 1.56 whereas for fiXate the load was 19.54 lbs with a standard deviation of 2.24.
These data suggest a novel semiautomated device offers a method of fixation that may be utilized in lieu of standard suturing methods as a means of securing neuromodulation devices. Data suggest the novel semiautomated device in fact may provide a more secure fixation than standard suturing methods.
脊髓刺激是治疗躯干或四肢慢性神经性疼痛的一种成熟疗法。目前,固定的标准方法是通过手动系普通缝线将神经调节装置的导线固定在软组织、筋膜或韧带上。本文提出了一种新型半自动装置,它可能比当前标准方法更具优势。我们在切除的山羊脊柱和模拟台式模型上进行了对比测试。
进行了三项测试:1)从山羊脊柱筋膜进行垂直牵拉;2)从山羊脊柱筋膜进行轴向牵拉;3)从聚酯薄膜进行轴向牵拉。每种配置的六个样本在每种情况下都进行了测试。将标准的2-0 Ethibond缝线与新型半自动装置(Anulex fiXate)进行比较。测试完成后,对每种情况进行统计分析。
在山羊脊柱垂直牵拉测试中,标准缝线的失效负荷为8.95磅,标准差为1.39,而fiXate装置的负荷为15.93磅,标准差为2.09。在山羊脊柱轴向牵拉测试中,标准缝线的失效负荷为6.79磅,标准差为1.55,而fiXate装置的负荷为12.31磅,标准差为4.26。在聚酯薄膜轴向牵拉测试中,标准缝线的失效负荷为10.87磅,标准差为1.56,而fiXate装置的负荷为19.54磅,标准差为2.24。
这些数据表明,一种新型半自动装置提供了一种固定方法,可用于替代标准缝合方法来固定神经调节装置。数据表明,这种新型半自动装置实际上可能比标准缝合方法提供更牢固的固定。