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KMID : 1150120150010010030
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Asian Journal of Pain
2015 Volume.1 No. 1 p.30 ~ p.35
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Spinal Neurostimulation for Pain Control: A Review
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Lee Tae-Kyu
Cho Kyung-Souk
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Abstract
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Management of pain by neurostimulation began shortly after Melzack and Wall proposed the gate control theory in 1965. Spinal neuromodulation for pain relief is most frequently delivered through spinal cord of cervical and thoracolumbar region. The stimulation of these regions by spinal cord stimulation (SCS) has proven its effectiveness for treating a number of neuropathic and nociceptive pain states that are not responsive nor amenable to medication and other known therapies. SCS is somewhat different intracranial neurostimulation for the treatment of medically intractable pain. However, the increasing use of SCS for the treatment of chronic pain, especially for pain not responsive to other neuromodulation techniques, reflects the efficacy and relative safety of these epidural procedures. In 1971, Shimoji and colleagues first reported the analgesic properties of epidural spinal cord stimulation. Since then SCS has undergone numerous technical and clinical developments. SCS represents one of the earliest uses of neuromodulation to treat chronic pain that is refractory to medical therapy. Currently, two kinds of SCS are commonly used to control pain: percutaneous lead technique and surgical lead after laminectomy. SCS has shown particular promise in the treatment of a number of nociceptive and neuropathic pain states, including post spinal surgery syndrome (PSSS), complex regional pain syndrome (CRPS), post-herpetic neuralgia (PHN), ischemic pain, peripheral vascular disease (PVD), angina, visceral pain and pelvic pain. This article will review the scientific rationale, indications, surgical techniques, and outcomes of SCS for the treatment of chronic pain.
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KEYWORD
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Spinal cord stimulation, Chronic pain, Neuropathic pain
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