Chapter

Spinal cord stimulation

Brian A. Simpson

in Neuropathic Pain

Second edition

Published on behalf of Oxford University Press

ISBN: 9780199563678
Published online May 2011 | e-ISBN: 9780199607426 | DOI: http://dx.doi.org/10.1093/med/9780199563678.003.0017

Series: Oxford Pain Management Library

Spinal cord stimulation

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• Electricity has been used for centuries to relieve pain but spinal cord stimulation (SCS) came about with the Gate Control Theory in the 1960s • SCS was originally thought simply to ‘close the gate’ by activating Aβ fibres but its effect is more complex. It is likely that it helps to normalize the dysfunction that manifests as neuropathic pain • SCS is most effective for neuropathic and ischaemic pain, and is ineffective in nociceptive pain • Electrodes are placed in the epidural space either via percutaneous needle or at open operation. The power source is usually implanted and is similar to a cardiac pacemaker • SCS can produce significant benefits in terms of pain and function in up to 70% of patients with neuropathic pain, though more controlled trials are needed to establish long-term benefits.

Chapter.  2161 words.  Illustrated.

Subjects: Anaesthetics ; Pain Medicine

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