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Review
. 2011 Jan-Jun;5(1):20-7.
doi: 10.4103/0259-1162.84174.

Spinal cord stimulation: Current applications for treatment of chronic pain

Prasad Vannemreddy  1 , Konstantin V Slavin  1
Affiliations
Review

Spinal cord stimulation: Current applications for treatment of chronic pain

Prasad Vannemreddy et al. Anesth Essays Res. 2011 Jan-Jun.

Abstract

Spinal cord stimulation (SCS) is thought to relieve chronic intractable pain by stimulating nerve fibers in the spinal cord. The resulting impulses in the fibers may inhibit the conduction of pain signals to the brain, according to the pain gate theory proposed by Melzack and Wall in 1965 and the sensation of pain is thus blocked. Although SCS may reduce pain, it will not eliminate it. After a period of concern about safety and efficacy, SCS is now regaining popularity among pain specialists for the treatment of chronic pain. The sympatholytic effect of SCS is one of its most interesting therapeutic properties. This effect is considered responsible for the effectiveness of SCS in peripheral ischemia, and at least some cases of complex regional pain syndrome. The sympatholytic effect has also been considered part of the management of other chronic pain states such as failed back surgery syndrome, phantom pain, diabetic neuropathy, and postherpetic neuralgia. In general, SCS is part of an overall treatment strategy and is used only after the more conservative treatments have failed. The concept of SCS has evolved rapidly following the technological advances that have produced leads with multiple contact electrodes and battery systems. The current prevalence of patients with chronic pain requiring treatment other than conventional medical management has significantly increased and so has been the need for SCS. With the cost benefit analysis showing significant support for SCS, it may be appropriate to offer this as an effective alternative treatment for these patients.

Keywords: Back pain; chronic pain; failed back surgery; spinal cord injury; spinal cord stimulator.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Single octrode stimulation lead over lumbosacral region. X-ray AP view
Figure 2 (a-b)
Figure 2 (a-b)
AP and lateral views of thoracic spine x ray showing Two electrodes in midline. The lateral view shows leads position dorsal to the dural sac
Figure 3
Figure 3
AP view of two stimulation leads in midline position. Note the juxta position of the contact points
See this image and copyright information in PMC

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