Spinal cord stimulation for intractable pain

Abstract

Spinal cord stimulation (SCS) is a well-established treatment modality for refractory chronic pain. The factors that are significant in assuring the success of this therapy include appropriate patient selection, stimulation site, and stimulation method. SCS has a significant analgesic effect on peripheral neuropathic pain and ischemic pain. Although a detailed mechanism of the action of SCS has not been elucidated, proper stimulation of the dorsal column of the spinal cord is thought to be necessary for obtaining an analgesic effect. The optimal placement of electrodes is of great importance, that is, these should be sufficiently covering the pain area. Recently, new waveform types for SC (ultra high-frequency stimulation and burst stimulation) have become available, and good outcomes have been reported with a high level of evidence.