Skip to main content

Neuromodulation

  • Chapter
  • 2793 Accesses

Abstract

Spinal cord stimulation is an advanced interventional pain management therapy. By implanting electrodes, impulses can be directed at adjacent nervous structures within both the central and peripheral nervous system to modulate pain sensation. Proper patient selection and lead placement are paramount to obtaining high success rates and pain relief. This chapter details the process of selecting ideal candidates, the trial and permanent implantation techniques, and patient management postoperatively.

Keywords

  • Spinal cord stimulation
  • Neuromodulation
  • Failed back surgery syndrome
  • Complex regional pain syndrome
  • Neuropathic pain
  • Percutaneous trial
  • Permanent implant
  • Implantable pulse generator

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-1-4939-2462-2_45
  • Chapter length: 7 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   119.00
Price excludes VAT (USA)
  • ISBN: 978-1-4939-2462-2
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   159.99
Price excludes VAT (USA)
Fig. 45.1
Fig. 45.2
Fig. 45.3
Fig. 45.4

Abbreviations

ADL:

Activity of daily living

AP:

Anteroposterior

ASC:

Ambulatory surgical center

CBC:

Complete blood count

CNS:

Central nervous system

CPT:

Current procedural terminology

CRPS:

Complex regional pain syndrome

CT:

Computed tomography

DRG:

Dorsal root ganglia

ECG:

Echocardiogram

ESR:

Erythrocyte sedimentation rate

FDA:

Food and Drug Administration

GABA:

Gamma-aminobutyric acid

IPG:

Implantable pulse generator

IV:

Intravenous

MAC:

Minimal anesthetic concentration

MRI:

Magnetic resonance imaging

MRSA:

Methicillin-resistant staphylococcus aureus

NSAID:

Non-steroidal anti-inflammatory drug

PCN:

Penicillin

PDPH:

Postdural puncture headache

SCI:

Spinal cord injury

SCS:

Spinal cord stimulator

UA:

Urinalysis

VAS:

Visual analog scale

References

  1. Melzack R, Wall PD. Textbook of pain. Edinburgh: Churchill Livingstone; 1989.

    Google Scholar 

  2. Stojanovic MP. Neuromodulation techniques for the treatment of pain. In: Ballantyne JC, editor. The Massachusetts general hospital handbook of pain management. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 193–203.

    Google Scholar 

  3. Kreis P, Fishman M. Spinal cord stimulation implantation: percutaneous implantation techniques. Oxford: Oxford University Press; 2009. p. 2, 12–14, 47, 129–130, 132–141.

    Google Scholar 

  4. Kebaish KM, Awad JN. Spinal epidural hematoma causing acute cauda equina syndrome. Neurosurg Focus. 2004;16:e1.

    CrossRef  PubMed  Google Scholar 

  5. Kumar K, Toth C, Nath RK, Laing P. Epidural spinal cord stimulation for treatment of chronic pain—some predictors of success. A 15-year experience. Surg Neurol. 1998;50(2):110–20.

    CrossRef  CAS  PubMed  Google Scholar 

  6. Wheeler AH, Burchiel KJ. Spinal Cord Stimulation. Medscape. 2013.

    Google Scholar 

  7. Molon G, Perrone C, Maines M, Costa A, Comisso J, Boi A, Moro E, Vergara G, Barbieri E. ICD and neuromodulation devices: is peaceful coexistence possible? Pacing Clin Electrophysiol. 2011;34(6):690–3.

    CrossRef  PubMed  Google Scholar 

  8. Stojanovic MP, Abdi S. Spinal cord stimulation. Pain Physician. 2002;5(2):156–66.

    PubMed  Google Scholar 

  9. North RB, Kidd DH, Farrokhi F, Piantadosi SA. Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurgery. 2005;56(1):98–106.

    PubMed  Google Scholar 

  10. Kemler MA, de Vet HC, Barendse GA, van den Wildenberg FA, van Kleef M. Effect of spinal cord stimulation for chronic complex regional pain syndrome type I: five-year final follow-up of patients in a randomized controlled trial. J Neurosurg. 2008;108(2):292–8.

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tim Canty M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Canty, T. (2015). Neuromodulation. In: Sackheim, K. (eds) Pain Management and Palliative Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2462-2_45

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2462-2_45

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2461-5

  • Online ISBN: 978-1-4939-2462-2

  • eBook Packages: MedicineMedicine (R0)