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Neuromodulation for Non-urologic Chronic Pain

  • Michael D. Staudt
  • Jonathan P. Miller
Chapter

Abstract

Neuromodulation, referring to the targeted electrical or pharmacological modification of nervous system activity, has a decades-long history in the development of unique treatment modalities for chronic pain syndromes. The interventional treatment of pain has gradually shifted from lesional (permanent) to neuromodulatory (reversible). Advances in neuromodulation technology have been most effective in the treatment of neuropathic pain, which is notoriously difficult to treat and refractory to conventional measures. Spinal cord stimulation is the best known and most widely used neuromodulatory treatment modality for chronic pain, although there is great interest in additional paradigms including peripheral nerve stimulation, deep brain stimulation, motor cortex stimulation, and intrathecal drug delivery. As these technologies have matured, the clinical indications have expanded and the technology has become more sophisticated. Accordingly, there exists a high-quality body of evidence to support the use of various neuromodulation devices, based off randomized control trials, prospective and retrospective series, and expert opinion. The aim of this chapter is to provide a brief overview of the most commonly-employed neuromodulation procedures in the treatment of chronic non-urologic pain. The historical origins of these technologies will be discussed alongside the current clinical indications and evidence.

Keywords

Neuromodulation Neurostimulation Spinal cord stimulation Peripheral nerve stimulation Deep brain stimulation Motor cortex stimulation Intrathecal drug delivery Neuropathic pain Nociceptive pain Chronic pain 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurological SurgeryUniversity Hospitals Cleveland Medical Center/Case Western Reserve UniversityClevelandUSA

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