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Published on: 2/16/2004
Last Visited: 11/16/2008
NMFF's Joshua Rosenow, M.D., director of functional neurosurgery at Northwestern Memorial Hospital, was recently awarded the Ronald Tasker Award for Pain Research at the 53rd annual meeting of the Congress of Neurological Surgeons in Denver, Colorado.
Dr. Rosenow and his colleagues' research was the largest analysis to date regarding the failure rates of spinal cord stimulators (SCS).
Dr. Rosenow recently came to Northwestern from the Cleveland Clinic Foundation.
He specializes in deep brain stimulation for the treatment of Parkinson's disease and other conditions, surgery for epilepsy, surgery for chronic pain, spasticity, stereotactic surgery and functional brain mapping.
Study findings helped doctors to determine which areas of the SCS system needed to be improved and which are working effectively.
"As a result, we continue to work to refine and advance our surgical techniques using the current hardware.
For example, we have changed the way we anchor the implant, thereby preventing it from breaking when the patient moves," explains Dr. Rosenow.
"Northwestern Memorial is leading the way to finding the best possible treatment options for patients with advanced pain and this award is further evidence of that dedication."
"While spinal cord stimulation has been around for over thirty years and is commonly used to diminish pain in patients with certain types of neuropathic pain, the incidence of complications related to the implanted hardware had not been extensively studied," said Dr. Rosenow.
"We knew that there were things about the device that we could improve, but no scientific study had been done to look at the rate of complications and analyze how and why they occurred."
The study found that 48 percent of patients required at least one revision of their hardware.
Of the patients who required one revision, 46 percent required more than one revision.
"In addition, we found that certain types of hardware had greater tendency to fail when placed in certain parts of the spine," explains Dr. Rosenow.
"Some of these findings went against previously widely held assumptions among pain physicians."
"We also discovered that other widely held notions regarding SCS were incorrect," continues Dr. Rosenow.
"For example, doctors had always thought risk of infection was common to all regions of the spine.
Our study showed, however, that hardware can be placed in certain parts of the spine that have a much lower tendency to become infected than others, allowing us to adjust our technique to greatly reduce the frequency of infection."
Dr. Rosenow is currently working with the product's manufacturer to assess the data in various ways, as well as discuss new hardware options.
"We are working to create new devices that will further perfect this technique," said Dr. Rosenow.
To carry out this research, Dr. Rosenow conducted a retrospective review of the electronic charts of patients who were operated on for implantation or revision of SCS from January 1998 through December 2002.
A total of 294 patients were operated on during the study period.
This story was originally publish on Northwestern Memorial Hospital's Web site.
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Photo Caption: Dr. Rosenow reviews the scan of a woman who recently received a spinal cord stimulator.
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