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Spinal Cord Stimulation

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Regional Nerve Blocks in Anesthesia and Pain Therapy

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Abstract

Spinal cord stimulation (SCS) has been used for several decades and just recently is considered a superior treatment for patients with chronic, intractable pain. Historically, using traditional low-frequency (40–90 Hz) SCS, the patient feels paresthesia located over the painful area and pain relief due to spinal and supraspinal mechanisms. About 30–50% of patients respond to conventional SCS therapy. Recent advances in SCS therapies are already improving SCS outcomes. For example, continuous stimulation at a higher frequency (10 kHz) was shown to provide superior pain relief for low back and leg pain compared to traditional lower SCS frequencies. Additionally, studies have indicated that 1 kHz continuous stimulation, or 500 Hz burst patterns of stimulation, may provide some additional pain-relieving benefit, while closed-loop type of SCS, or differential target multiplex therapy, could provide a profound pain relief comparable in outcomes to 10 kHz SCS.

More recently, new clinical indications for SCS were explored including peripheral neuropathy in diabetes, cervical radiculopathy, and abdominal and pelvic pain. As a result of the profound pain control, improvement in functional capacity and decrease in the use of opioids that is associated with the use of SCS, one can expect to see a significant increase in the utilization of SCS in years to come.

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Authors and Affiliations

  1. Carolinas Pain Institute and Chronic Pain Research Institute, Winston-Salem, NC, USA

    Leonardo Kapural & James Deering

Authors
  1. Leonardo Kapural
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  2. James Deering
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Editors and Affiliations

  1. DGS – Cologne – Huerth, Cologne-Hürth, Germany

    Danilo Jankovic

  2. Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON, Canada

    Philip Peng

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Kapural, L., Deering, J. (2022). Spinal Cord Stimulation. In: Jankovic, D., Peng, P. (eds) Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-88727-8_72

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  • DOI: https://doi.org/10.1007/978-3-030-88727-8_72

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