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Article ; Online: A Preface to the Introduction of an Updated and Revised International Neuromodulation Society Conflict of Interest Policy.

Levy, Robert M / Piedimonte, Fabian / Bojanic, Stana / Teddy, Peter

Neuromodulation : journal of the International Neuromodulation Society

2021 Volume 24, Issue 1, Page(s) 1–2

MeSH term(s)	Conflict of Interest ; Humans ; Policy
Language	English
Publishing date	2021-01-27
Publishing country	United States
Document type	Editorial
ZDB-ID	1500372-3
ISSN	1525-1403 ; 1094-7159
ISSN (online)	1525-1403
ISSN	1094-7159
DOI	10.1111/ner.13330
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Article: Das „Interdisciplinary Spine Fellowship” in England

Rothenfluh, Dominique A / Reynolds, Jeremy / Bojanic, Stana

Die Wirbelsäule

2021 Volume 5, Issue 01, Page(s) 21–25

Abstract: Die Wirbelsäulenchirurgie hat sich zu einer Subspezialität von Orthopädie und Neurochirurgie entwickelt, obwohl offiziell zurzeit noch nicht als solche anerkannt. Speziell in England haben hohe Wartezeiten für Patienten und geografische Lücken in der ... ...

Abstract	Die Wirbelsäulenchirurgie hat sich zu einer Subspezialität von Orthopädie und Neurochirurgie entwickelt, obwohl offiziell zurzeit noch nicht als solche anerkannt. Speziell in England haben hohe Wartezeiten für Patienten und geografische Lücken in der Versorgung von Wirbelsäulenpatienten die Bildung von Wirbelsäulennetzwerken begünstigt. Damit in dieser Struktur die Qualität verbessert werden kann, muss die Variabilität von Entscheidungen und Behandlungskonzepten vermindert werden. Dies soll mit einer strukturierten Weiterbildung gelingen, welche die speziellen Aspekte von Orthopädie und Neurochirurgie beinhaltet. Es wird erwartet, dass ein Fellowship die Kompetenz der Chirurgen erhöht und so die Qualität und Behandlungsresultate verbessert. Das interdisziplinäre Fellowship der Spinal Training Interface Group (STIG) vereinigt Lerninhalte von Orthopädie und Neurochirurgie in einem definierten Weiterbildungscurriculum. Dieses hat die Lernziele zur praktischen Umsetzung als sog. „Skills” in 4 Module eingeteilt: Allgemeine Prinzipien, Kritische Erkrankungen, Pathologische Wirbelsäule und optional Fortgeschrittene Behandlungsmethoden. Um die Bedingungen zur Komplettierung des Fellowships zu erfüllen, muss die Absolvierung der einzelnen Skills dokumentiert sein. Das Fellowship dauert mindestens ein Jahr. Die strukturierte Weiterbildung im Rahmen des interdisziplinären Fellowships soll so eine flächendeckende qualitativ hochstehende Grundversorgung gewährleisten und sicherstellen, dass Spezialwissen und Fertigkeiten dort zur Verfügung stehen, wo sie benötigt werden.
Keywords	Weiterbildung ; Wirbelsäule ; Fellowship ; STIG ; Training ; Spine ; Surgery Fellowship ; STIG
Language	German
Publishing date	2021-02-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	2509-825X ; 2509-8241
ISSN (online)	2509-825X
ISSN	2509-8241
DOI	10.1055/a-1264-8825
Database	Thieme publisher's database

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Article: Best Practices from the American Society of Pain and Neuroscience (ASPN) for Clinical Research During a Pandemic or Emergency.

Petersen, Erika A / Deer, Timothy R / Bojanic, Stana / Sankary, Lauren R / Strand, Natalie H / Al Kaisy, Adnan / Huygen, Frank / Sayed, Dawood / Steegers, Monique / Verrills, Paul / Schatman, Michael E

Journal of pain research

2023 Volume 16, Page(s) 327–339

Abstract: The COVID-19 pandemic caught many areas of medicine in a state of unpreparedness for conducting research and completing ongoing projects during a global crisis, including the field of pain medicine. Waves of infection led to a disjointed ability to ... ...

Abstract	The COVID-19 pandemic caught many areas of medicine in a state of unpreparedness for conducting research and completing ongoing projects during a global crisis, including the field of pain medicine. Waves of infection led to a disjointed ability to provide care and conduct clinical research. The American Society of Pain and Neuroscience (ASPN) Research Group has created guidance for pragmatic and ethical considerations for research during future emergency or disaster situations. This analysis uses governmental guidance, scientific best practices, and expert opinion to address procedure-based or device-based clinical trials during such times. Current literature offers limited recommendations on this important issue, and the findings of this group fill a void for protocols to improve patient safety and efficacy, especially as we anticipate the impact of future disasters and spreading global infectious diseases. We recommend local adaptations to best practices and innovations to enable continued research while respecting the stressors to the research subjects, investigator teams, health-care systems, and to local infrastructure.
Language	English
Publishing date	2023-02-01
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S393539
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Article ; Online: Dorsal Root Ganglion Stimulation for the Treatment of Chronic Neuropathic Knee Pain.

Martin, Sean C / Macey, Alistair R / Raghu, Ashley / Edwards, Tamara / Watson, Clare / Bojanić, Stana / FitzGerald, James J / Green, Alexander L

World neurosurgery

2020 Volume 143, Page(s) e303–e308

Abstract: Background: To elucidate the efficacy of dorsal root ganglion stimulation in the treatment of chronic neuropathic pain confined to the knee.: Methods: Retrospective analysis of prospectively collected data of 14 consecutive patients undergoing dorsal ...

Abstract	Background: To elucidate the efficacy of dorsal root ganglion stimulation in the treatment of chronic neuropathic pain confined to the knee. Methods: Retrospective analysis of prospectively collected data of 14 consecutive patients undergoing dorsal root ganglion stimulation for chronic knee pain, in a single center. The primary outcome measure was pain reduction assessed by numeric pain rating scale score preoperatively and postoperatively. Secondary outcomes included quantification of percentage of pain area covered by stimulation, and reduction in usage of opioid medications. Responders were defined as patients that experienced a greater than or equal to 50% improvement in their preoperative pain score. Results: Fourteen patients were implanted with dorsal root ganglion stimulator electrodes; 8 had a single L3 lead implanted, 1 patient had a single L4 lead implanted, and 3 patients had 2 leads implanted (L3 and L4). Two patients had their leads explanted: 1 for non-efficacy, and 1 for repeated electrode displacement. The most common indication for surgery was type 2 complex regional pain syndrome, secondary to either trauma or postoperative chronic pain (either knee replacement or arthroscopy). Median preoperative numeric rating scale score was 8.5, median postoperative numeric rating scale score was 2 (P = 0.002, Wilcoxon signed rank test). The median improvement in pain score was 80%. All 12 patients undergoing chronic stimulation were responders. Median coverage of pain area was 85%. All but 1 patient who was on opioid medication prior to surgery had reduced the dosage of regular opioid. Conclusions: In selected patients, dorsal root ganglion stimulation is an extremely efficacious means of treating otherwise refractory chronic knee pain.
MeSH term(s)	Adult ; Aged ; Arthralgia/diagnostic imaging ; Arthralgia/therapy ; Chronic Pain/diagnostic imaging ; Chronic Pain/therapy ; Female ; Ganglia, Spinal/diagnostic imaging ; Humans ; Knee Joint/diagnostic imaging ; Male ; Middle Aged ; Neuralgia/diagnostic imaging ; Neuralgia/therapy ; Pain Measurement/methods ; Prospective Studies ; Retrospective Studies ; Spinal Cord Stimulation/methods ; Treatment Outcome
Language	English
Publishing date	2020-07-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.07.102
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Article ; Online: High and low pressure headaches: a spinal cause.

Petkovic, Grace / Rose-Innes, Elizabeth / Bojanic, Stana / Leite, Maria Isabel / Wakerley, Benjamin R

Practical neurology

2018 Volume 18, Issue 5, Page(s) 413–414

Language	English
Publishing date	2018-05-18
Publishing country	England
Document type	Editorial
ZDB-ID	2170881-2
ISSN	1474-7766 ; 1474-7758
ISSN (online)	1474-7766
ISSN	1474-7758
DOI	10.1136/practneurol-2017-001769
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Article ; Online: The Efficacy and Safety of Dorsal Root Ganglion Stimulation as a Treatment for Neuropathic Pain: A Literature Review.

Harrison, Conrad / Epton, Sarah / Bojanic, Stana / Green, Alexander L / FitzGerald, James J

Neuromodulation : journal of the International Neuromodulation Society

2017 Volume 21, Issue 3, Page(s) 225–233

Abstract: Objective: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower ...

Abstract	Objective: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower limb complex regional pain syndrome (CRPS) and causalgia has recently been published. Methods: In this review we have summarized the literature to date on the use of DRGS in the treatment of neuropathic pain. Results: The results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain. Treatment of failed back surgery syndrome (FBSS) appears less successful. The therapy is still young, and long term results are not yet available. There is now good randomized clinical trial (RCT) evidence that DRGS provides superior pain relief to spinal cord stimulation for CRPS and causalgia of the lower limb, and produces stimulation that is more posturally stable, with more precise paraesthesia coverage. However evidence of this quality for other indications and pain locations is lacking. Conclusion: There is now Class A RCT evidence that DRGS provides superior pain relief to SCS for CRPS and causalgia of the lower limb. In the coming years we hope that randomized controlled trials will be performed on an indication-by-indication basis, which, together with the publication of longer term follow-up data, will provide a more complete understanding of the role of DRGS in the treatment of neuropathic pain syndromes.
MeSH term(s)	Electric Stimulation Therapy/methods ; Ganglia, Spinal/physiology ; Humans ; Neuralgia/therapy ; Pain Management/methods
Language	English
Publishing date	2017-09-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1500372-3
ISSN	1525-1403 ; 1094-7159
ISSN (online)	1525-1403
ISSN	1094-7159
DOI	10.1111/ner.12685
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Article: Role of diffusion-weighted imaging in monitoring treatment response following high-intensity focused ultrasound ablation of recurrent sacral chordoma.

Chetan, Madhurima R / Lyon, Paul C / Wu, Feng / Phillips, Rachel / Cranston, David / Gillies, Martin J / Bojanic, Stana

Radiology case reports

2019 Volume 14, Issue 10, Page(s) 1197–1201

Abstract: Chordoma is the most common malignant tumor of the sacrum and is associated with significant neurologic morbidity. Local recurrence is very common, and the long-term prognosis is poor. High-intensity focused ultrasound (HIFU) is a noninvasive and ... ...

Abstract	Chordoma is the most common malignant tumor of the sacrum and is associated with significant neurologic morbidity. Local recurrence is very common, and the long-term prognosis is poor. High-intensity focused ultrasound (HIFU) is a noninvasive and nonionising ablative therapy that has been successful in treating other tumor types and is being evaluated as a new therapy for sacral chordoma. Contrast-enhanced magnetic resonance imaging is typically used to evaluate tumor perfusion following HIFU; however, its utility is limited in poorly perfused tumors. Diffusion-weighted imaging (DWI) provides tissue contrast based on differences in the diffusion of extracellular water without using gadolinium-based contrast agents. We present novel DWI findings following a planned partial HIFU ablation of a large sacral chordoma which had recurred after radiotherapy. Following HIFU, the treated tumor volume demonstrated loss of restriction on DWI correlating with photopenia on positron emission tomography. This suggests successful ablation and tumor necrosis. This novel finding may provide guidance for sequence selection when evaluating HIFU therapy for sacral chordoma and other tumor types for which contrast-enhanced magnetic resonance imaging may have limited utility.
Language	English
Publishing date	2019-08-01
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2019.07.004
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Article ; Online: Burst or Conventional Peripheral Nerve Field Stimulation for Treatment of Neuropathic Facial Pain.

Manning, Andrew / Ortega, Rodrigo Garcia / Moir, Liz / Edwards, Tamara / Aziz, Tipu Z / Bojanic, Stana / Green, Alexander L / Fitzgerald, James J

Neuromodulation : journal of the International Neuromodulation Society

2019 Volume 22, Issue 5, Page(s) 645–652

Abstract: Background: Trigeminal Neuropathic Pain (TNP) is a chronic facial pain syndrome caused by a lesion or disease affecting one or more branches of the trigeminal nerve. It may, for example, result from accidental injury to a branch of the trigeminal nerve ... ...

Abstract	Background: Trigeminal Neuropathic Pain (TNP) is a chronic facial pain syndrome caused by a lesion or disease affecting one or more branches of the trigeminal nerve. It may, for example, result from accidental injury to a branch of the trigeminal nerve by trauma or during surgery; it may also be idiopathic. TNP is typically constant, in contrast to most cases of the commoner trigeminal neuralgia. In some cases, pain may be refractory to pharmacological treatment. Peripheral nerve field stimulation is recognized as an effective minimally invasive surgical treatment option for this debilitating condition. To date, stimulation has used conventional tonic waveforms, which generate paraesthesia in the stimulated area. This is the first report of the use of paraesthesia-free burst pattern stimulation for TNP. Methods: Seven patients were treated at the John Radcliffe Hospital for TNP from 2016 to 2018. Mean duration of preoperative symptoms was five years. All patients had exhausted pharmacological measures to limited effect. The initial three patients had tonic stimulation with the subsequent four having burst stimulation. Outcome was assessed using the numeric pain rating scale preoperatively and postoperatively at three and six months and one year. Side-effects and complications were also assessed as well as reduction in analgesic medication use. Results: All patients achieved pain reduction of at least 50% at 6 months (range 50-100%, mean 81%, p = 0.0082). Those in the burst stimulation group were paraesthesia free. One patient developed a postoperative infection for which the system had to be removed and is awaiting reimplantation. There were no other complications in either group. Conclusion: Burst stimulation conferred similar pain control to tonic stimulation in our small cohort, and there were similar reductions in pain medication use. An additional benefit of burst stimulation is freedom from paraesthesia. Larger scale studies are needed to further evaluate burst stimulation and compare its efficacy with that of tonic stimulation.
MeSH term(s)	Adult ; Aged ; Electric Stimulation Therapy/instrumentation ; Electric Stimulation Therapy/methods ; Electrodes, Implanted ; Facial Neuralgia/diagnostic imaging ; Facial Neuralgia/therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain Management/instrumentation ; Pain Management/methods ; Peripheral Nerves/physiology ; Transcutaneous Electric Nerve Stimulation/instrumentation ; Transcutaneous Electric Nerve Stimulation/methods ; Treatment Outcome ; Trigeminal Neuralgia/diagnostic imaging ; Trigeminal Neuralgia/therapy
Language	English
Publishing date	2019-01-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1500372-3
ISSN	1525-1403 ; 1094-7159
ISSN (online)	1525-1403
ISSN	1094-7159
DOI	10.1111/ner.12922
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Article ; Online: The Importance of the Location of Dorsal Root Ganglion Stimulator Electrodes Within the Nerve Root Exit Foramen.

Martin, Sean / Hadjipavlou, George / Garcia Ortega, Rodrigo / Moir, Liz / Edwards, Tamara / Bojanic, Stana / Green, Alexander L / FitzGerald, James J

Neuromodulation : journal of the International Neuromodulation Society

2019 Volume 23, Issue 2, Page(s) 245–251

Abstract: Objective: To quantify the relationship between the electrical power requirement to achieve pain relief and the position of the active electrode of dorsal root ganglion stimulators within the spinal nerve root exit foramen.: Materials and methods: ... ...

Abstract	Objective: To quantify the relationship between the electrical power requirement to achieve pain relief and the position of the active electrode of dorsal root ganglion stimulators within the spinal nerve root exit foramen. Materials and methods: Retrospective analysis of prospectively collected data of 92 consecutive patients undergoing dorsal root ganglion stimulation (DRGS) for chronic pain in a single center. Cervical and sacral cases, and failed trials/explanted DRGS were excluded, so we report on 57 patients with 78 implanted leads. Anteroposterior and lateral fluoroscopic images of the lead in the exit foramen were examined, and the active electrode positions were put into categories depending on their location relative to fixed anatomical landmarks. The clinical outcome and the power requirements for each of these groups of electrodes were then analyzed. Overall pain outcome was assessed by numeric pain rating scale score pre-operatively and post-operatively. Results: There was no significant relationship between power requirements and mediolateral electrode position, although the lowest average was observed with electrode positions directly below the center of the pedicle. On lateral x-ray, the lowest power requirements were observed in the electrodes positioned superodorsally or dorsally within the foramen. Importantly, power requirements in this location were consistently low, while the power requirements in other locations were not only higher but also much more variable. Electrodes in the superodorsal position required a median output power almost four times lower than electrodes in other positions (p = 0.002). Clinical outcome was not significantly related to power requirement or foraminal position. Conclusion: Aiming for a superodorsal electrode position on lateral intraoperative fluoroscopy is desirable, since siting leads in this location reduces the required stimulator output power very substantially and thus will extend battery life. Position within the foramen does not determine clinical outcome, and so the implanter can safely aim for the low power site without detriment to the analgesic efficacy of the system.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Ganglia, Spinal/diagnostic imaging ; Humans ; Implantable Neurostimulators/standards ; Male ; Middle Aged ; Pain/diagnostic imaging ; Pain Management/instrumentation ; Pain Management/standards ; Prospective Studies ; Retrospective Studies ; Spinal Cord Stimulation/instrumentation ; Spinal Cord Stimulation/standards ; Spinal Nerve Roots/diagnostic imaging ; Young Adult
Language	English
Publishing date	2019-05-09
Publishing country	United States
Document type	Case Reports
ZDB-ID	1500372-3
ISSN	1525-1403 ; 1094-7159
ISSN (online)	1525-1403
ISSN	1094-7159
DOI	10.1111/ner.12959
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Article ; Online: Oxford craniotomy infections database: a cost analysis of craniotomy infection.

O'Keeffe, Andrew B / Lawrence, Timothy / Bojanic, Stana

British journal of neurosurgery

2012 Volume 26, Issue 2, Page(s) 265–269

Abstract: We describe the process of establishing a large database for the investigation of craniotomy infection and the preliminary results of this database. The initial results have been used to generate a cost analysis for craniotomy infection. The craniotomy ... ...

Abstract	We describe the process of establishing a large database for the investigation of craniotomy infection and the preliminary results of this database. The initial results have been used to generate a cost analysis for craniotomy infection. The craniotomy infections database prospectively registers craniotomy cases taking place in the John Radcliffe Hospital. In order to achieve this, each patient's details are registered at the time of operation and followed up to identify cases of infection. Infection was defined strictly according to Centre for Disease Control criteria and validated by at least two members of clinical staff. The first 10 months of data are presented here which identifies a total of 245 craniotomies and 20 verified craniotomy infections. An overall infection rate of 8% is identified, and the cost incurred by the neurosurgery department as a result of craniotomy infections is estimated at £1 85 660 for the 10-month period studied. This amounts to a cost per case of infection of £9283.
MeSH term(s)	Central Nervous System Diseases/economics ; Central Nervous System Diseases/etiology ; Central Nervous System Diseases/mortality ; Costs and Cost Analysis ; Craniotomy/adverse effects ; Craniotomy/economics ; Craniotomy/mortality ; Data Collection/economics ; Data Collection/methods ; Databases, Factual ; Female ; Follow-Up Studies ; Humans ; Infection/economics ; Infection/etiology ; Infection/mortality ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications/economics ; Postoperative Complications/etiology ; Prospective Studies ; Reoperation/economics ; Surgical Wound Infection/economics
Language	English
Publishing date	2012-04
Publishing country	England
Document type	Journal Article
ZDB-ID	639029-8
ISSN	1360-046X ; 0268-8697
ISSN (online)	1360-046X
ISSN	0268-8697
DOI	10.3109/02688697.2011.626878
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