Abstract
Spinal cord and peripheral nerve stimulation for relief of chronic intractable pain have been used since the mid-1960s. Multiple mechanisms of action have been theorized without a clear-cut winner. The early frustrations with patient selection criteria and equipment difficulties have diminished secondary to carefully controlled studies and improvements in equipment designs. Efficacy studies consistently show an overall 50% improvement in long-term pain control in patients who have failed conservative or other invasive modalities. With improvements in today’s technology, one hopes that better analgesia will be attainable.
Similar content being viewed by others
References and Recommended Reading
Shealy C, Mortimer J, Reswick J: Electrical inhibition of pain by stimulation of the dorsal columns: preliminary report. Anesth Analg 1967, 46:489–491.
Hunt W, Goodmanr J, Bingham Jr W: Stimulation of the dorsal spinal cord for treatment of intractable pain: a preliminary report. Surg Neurol 1975, 4:153–156.
Sweet W, Wepsic J: Stimulation of the posterior columns of the spinal cord for pain control. Surg Neurol 1975, 4:133.
Long D, Erickson D: Stimulation of the posterior columns of the spinal cord for relief of intractable pain. Surg Neurol 1975, 4:134–141.
Vaarwerk I, Staal M: Spinal cord stimulation in chronic pain syndromes. Spinal Cord 1998, 36:671–682.
Barolat G, Sharan A: Future trends in spinal cord stimulation. Neurol Res 2000, 22:279–284.
Melzack R, Wall P: Pain mechanisms: a new theory. Science 1965, 150:971–979.
North R, Roark G: Spinal cord stimulation for chronic pain. Neurosurg Clin North Am 1995, 6:145–155.
Calvillo O, Racz G, Dedie J, Smith K: Neuroaugmentation in the treatment of complex regional pain syndrome of the upper extremity. Acta Orthop Belg 1998, 64:57–63.
Ronk L: Spinal cord stimulation for chronic, nonmalignant pain. Orthop Nurs 1996, 15:53–58.
Freeman T, Campbell J, Long D: Naloxone does not effect pain relief induced by electrical stimulation in man. Pain 1983, 17:189–195.
Tonelli L, Setti T, Falasca A, et al.: Investigation on cerebrospinal fluid opioids and neurotransmitters related to spinal cord stimulation. Appl Neurophysiol 1988, 51:324–332.
Hawkes C, Fawcett D, Cooke E, et al.: Dorsal column stimulation in multiple sclerosis: effects on bladder, leg and peptides. Appl Neurophysiol 1981, 44:62–70.
Linderoth B, Gazelius B, Franck J, Brodin E: Dorsal column stimulation induces release of serotonin and substance P in the cat dorsal horn. Neurosurgery 1992, 31:289–296.
Krames E: Spinal cord stimulation: indications, mechanism of action, and efficacy. Curr Rev Pain 1999, 3:419–426. Excellent review of mechanisms of action for SCS.
Saade N, Tabet M, Banna N, et al.: Inhibition of nociceptive evoked activity in spinal neurons through dorsal columnspinal loop. Brain Res 1985, 339:115–118.
Linderoth B: Spinal cord stimulation in ischemia and ischemic pain. Possible mechanisms of action. In Spinal Cord Stimulation II. Edited by Horsch S, Claeys L. New York: Steinkoff Springer Verlag; 1995:19–35.
Oosterga M, Vaarwerk I, DeJongste M, Staal M: Spinal cord stimulation in refractory angina pectoris—clinical results and mechanisms. Z Kardiol 1997, 86:107–113.
Augustinsson L, Linderoth B, Mannheimer C, Eliasson T: Spinal cord stimulation in cardiovascular disease. Neurosurg Clin North Am 1995, 6:157–165.
Claeys L: Spinal cord stimulation for peripheral vascular disease: a critical review—European series. Pain Digest 1999, 9:337–341.
Eliasson T, Augustinsson L, Mannheimer C: Spinal cord stimulation in severe angina pectoris—presentation of current studies, indications and clinical experience. Pain 1996, 65:169–179.
Croom J, Foreman R, Chandler M, Barron K: Reevaluation of the role of the sympathetic nervous system in cutaneous vasodilation during spinal cord stimulation: are multiple mechanisms active? Neuromodulation 1998, 1:91–101.
Holsheimer J: Effectiveness of spinal cord stimulation in the management of chronic pain: analysis of technical drawbacks and solutions. Neurosurgery 1997, 40:990–996.
Muir A, Molloy A: Neuraxial implants for pain control. Int Anesthesiol Clin 1997, 35:171–196.
May R, Volker S: Chronic pain management and spinal cord stimulation: patient-screening guidelines to improve outcome. Pain Digest 1999, 9:353–363.
Abram S: Advances in chronic pain management since gate control. Reg Anesth 1993, 18:66–81.
Segal R, Stacey B, Rudy T, et al.: Spinal cord stimulation revisited. Neurol Res 1998, 20:391–396.
North R: Spinal cord stimulation for intractable pain: long-term follow-up. J Spinal Disord 1990, 3:356–361.
Kumar K, Toth C, Nath R: Spinal cord stimulation for chronic pain in peripheral neuropathy. Surg Neurol 1996, 46:363–369.
Tesfaye S, Watt J, Benbow S, et al.: Electrical spinal-cord stimulation for painful diabetic neuropathy. Lancet 1996, 348:1696–1701.
Waltz J, Scozzari C, Hunt D: Spinal cord stimulation in the treatment of spasmodic torticollis. Appl Neurophysiol 1985, 48:324–338.
Forrest D: Spinal cord stimulator therapy. J Perianesth Nurs 1996, 11:349–352.
Turner J, Loeser J, Bell K: Spinal cord stimulation for chronic low back pain: a systematic literature synthesis. Neurosurgery 1995, 37:1088–1095.
Simpson B: Spinal cord stimulation. Br J Neurosurg 1997, 11:5–11.
Shimoji K, Tamaki H, Tatsuhiko K, et al.: Management of intractable pain with percutaneous epidural spinal cord stimulation: differences in pain relieving effects among diseases and pain sites. Anesth Analg 1993, 77:110–116.
Racz G, McCarron R, Talboys P: Percutaneous dorsal column stimulator for chronic pain control. Spine 1989, 14:1–4.
Urban B, Nashold B: Percutaneous epidural stimulation of the spinal cord for relief of pain. J Neurosurg 1978, 48:323–328.
Shimoji K, Matsuki M, Shimizu H, et al.: Low-frequency, weak extradural stimulation in the management of intractable pain. Br J Anaesth 1977, 49:1081–1086.
Koeze T, de Williams A, Reiman S: Spinal cord stimulation and the relief of chronic pain. J Neurol Neurosurg Psychiatry 1987, 50:1424–1429.
Heidecke V, Rainov N, Burket W: Hardware failure in spinal cord stimulation for failed back surgery syndrome. Neuromodulation 2000, 3:27–30.
De La Porte C, Van de Kelft E: Spinal cord stimulation in failed back surgery syndrome. Pain 1993, 52:55–61.
Burchiel K, Anderson V, Brown F, et al.: Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain. Spine 1996, 21:2786–2794.
LeDoux M, Langford K: Spinal cord stimulation for the failed back syndrome. Spine 1993, 18:191–194.
North R, Kidd D, Zahurak M, et al.: Spinal cord stimulation for chronic, intractable pain: experience over two decades. Neurosurgery 1993, 32:384–394.
Ohnmeiss D, Rashbaum R, Bogdanffy G: Prospective outcome evaluation of spinal cord stimulation in patients with intractable leg pain. Spine 1996, 21:1344–1351.
Meglio M, Cioni B, Rossi G: Spinal cord stimulation in management of chronic pain. J Neurosurg 1989, 70:519–524.
Kumar K, Nath R, Wyant G: Treatment of chronic pain by epidural spinal cord stimulation: a 10-year experience. J Neurosurg 1991, 75:402–407.
Barolat G, Schwartzmann R, Woo R: Epidural spinal cord stimulation in the management of reflex sympathetic dystrophy. Proceedings of the Meeting of the American Society for Stereotactic and Functional Neurosurgery, Montreal 1987. Appl Neurophysiol 1987, 50:442–443.
Kemler M, Barendse G, Van Kleef M, et al.: Electrical spinal cord stimulation in reflex sympathetic dystrophy: retrospective analysis of 23 patients. J Neurosurg 1999, 90:79–83.
Oakley J, Weiner R: Spinal cord stimulation for complex regional pain syndrome: a prospective study of 19 patients at two centers. Neuromodulation 1999, 2:47–50.
Robaina F, Dominguez M, Diaz M, et al.: Spinal cord stimulation for relief of chronic pain in vasospastic disorders of the upper limbs. Neurosurgery 1989, 24:63–67.
Murphy D, Laffy J, O’Keeffe D: Electrical spinal cord stimulation for painful peripheral neuropathy secondary to coeliac disease [letter]. Gut 1998, 42:448–449.
Huber S, Vaglienti R, Midcap M: Enhanced limb salvage for peripheral vascular disease with the use of spinal cord stimulation. W V Med J 1996, 92:89–91.
Broseta J, Barbera J, de Vera J, et al.: Spinal cord stimulation in peripheral arterial disease. J Neurosurg 1986, 64:71–80.
Brodison A, Chauhan A: Spinal-cord stimulation in management of angina. Commentary. Lancet 1999, 354:1748–1749.
Murphy D, Giles K: Dorsal column stimulation for pain relief from intractable angina pectoris. Pain 1987, 28:365–368.
Anderson C, Hole P, Oxhoj H: Does pain relief with spinal cord stimulation for angina conceal myocardial infarction? Br Heart J 1994, 71:419–421.
Murray S, Carson K, Ewings P, et al.: Spinal cord stimulation significantly decreases the need for acute hospital admission for chest pain in patients with chronic refractory angina. Heart 1999, 82:89–92.
Sanchez-Ledesma M, Garcia-March G, Diaz-Cascajo P, et al.: Spinal cord stimulation in deafferentation pain. Stereotact Funct Neurosurg 1989, 53:40–45.
Cioni B, Meglio M, Pentimalli L, Visocchi M: Spinal cord stimulation in the treatment of paraplegic pain. J Neurosurg 1995, 82:35–39.
Waltz J: Spinal cord stimulation: a quarter century of development and investigation. Stereotact Funct Neurosurg 1997, 69:288–299.
Shetter A, Racz G, Lewis R, Heavner J: Peripheral nerve stimulation. In Neurosurgical Management of Pain. Edited by North R, Levy R. New York, NY: Springer-Verlag; 1997:261–270.
Leak W, Ansel A: Neural stimulation: spinal cord and peripheral nerve stimulation. In Pain Medicine: A Comprehensive Review. Edited by Raj P. St. Louis, Mo: Mosby; 1996:327–333.
Campbell J, Taub A: Local analgesia from percutaneous electrical stimulation. A peripheral mechanism. Arch Neurol 1973, 28:347–350.
Campbell J, Long D: Peripheral nerve stimulation in the treatment of intractable pain. J Neurosurg 1976, 45:692–699.
Law J, Swett J, Kirsch W: Retrospective analysis of 22 patients with chronic pain treated by peripheral nerve stimulation. J Neurosurg 1980, 52:482–485.
Nashold B, Goldner J, Mullen J, Bright D: Long-term pain control by direct peripheral-nerve stimulation. J Bone Joint Surg 1982, 64A:1–10.
North R, Ewend M, Lawton M, Piantadosi S: Spinal cord stimulation for chronic, intractable pain: superiority of “multi-channel” devices. Pain 1991, 44:119–130.
Holsheimer J: Computer modeling of spinal cord stimulation and its contribution to therapeutic efficacy. Spinal Cord 1998, 36:531–540. Extremely informative article on the use of computer modeling to improve the efficacy of SCS.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Day, M. Neuromodulation: Spinal cord and peripheral nerve stimulation. Current Review of Pain 4, 374–382 (2000). https://doi.org/10.1007/s11916-000-0021-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11916-000-0021-7