Abstract
The rationale for the use of spinal cord stimulation (SCS) in the treatment of chronic pain arose from Melzack and Wall’s gate theory of the control of pain (1965). Originally electrodes were placed directly on the spinal cord via open operation, while now they are placed by means of direct puncture the epidural space. In most cases, one of two different systems is used: (1) semi-implants, consisting of an implantable electrode, connection cable and receiver, and externally worn stimulator with antenna; (2) full implants, consisting of an implantable electrode, connection cable and a stimulator, which is also implanted. The implantation of an SCS system is a surgical procedure, which requires the highest standards in asepsis. The operation and its complications and ways of avoiding them are described.
Zusammenfassung
Die Methode der elektrischen Reizung des Rückenmarks mit implantierten Elektroden (SCS) in der Behandlung chronischer, kausal nicht therapierbarer Schmerzen geht zurück auf die Gate-Control Theorie des Schmerzes von Melzack und Wall [6]. Anfangs wurde die Elektrode direkt über einen offenen Eingriff an das Rückenmark gelegt, heute geschieht dies mit einer direkten Punktion des Epiduralraums. Zwei unterschiedliche Systeme sind derzeit hauptsächlich in Gebrauch: 1. Halbimplantate, bestehend aus implantierbarer Elektrode, Verbindungskabel und Empfänger sowie einem extern getragenen Stimulator mit Antenne; 2. Vollimplantate, bestehend aus einer implantierbaren Elektrode, Verbindungskabel und einem ebenso implantierbaren Stimulator. Die Implantation eines spinalen Reizsystems ist ein operativer Eingriff, welcher ein Höchstmaß an Asepsis erfordert. Implantationstechnik, Komplikationen und deren Vermeidung werden beschrieben.
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Krainick, J.U. Technische Entwicklung der spinalen Neurostimulation. Schmerz 5, 247–249 (1991). https://doi.org/10.1007/BF02527805
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DOI: https://doi.org/10.1007/BF02527805