RT Book, Section
A1 Wootton, R. Joshua
A2 Bajwa, Zahid H.
A2 Wootton, R. Joshua
A2 Warfield, Carol A.
SR Print(0)
ID 1131931676
T1 Psychological Evaluation of Patients for Spinal Cord Stimulator Implantation
T2 Principles and Practice of Pain Medicine, 3e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071766838
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1131931676
RD 2024/04/19
AB More  than  45  years  ago,  Shealy  and  colleagues  introduced  the  concept  of  spinal  cord  stimulation  (SCS)  as  a  means  of  electrically  inhibiting  pain  that  was  consonant  with  Melzack  and  Wall's  gate-control  theory  of  pain.1-3  SCS,  or  neuromodulation,  is  now  a  widely  used  technique  that  delivers  pulsed  electrical  signals,  principally  to  the  dorsal  column  of  the  spinal  cord,  for  indications  that  include  failed  back  surgery  syndrome,  traumatic  nerve  injury,  postherpetic  neuralgia,  complex  regional  pain  syndrome,  refractory  angina  pectoris,  peripheral  vascular  disease,  neuropathic  pain,  and  visceral  pain.4,5  The  technique  is  minimally  invasive  and  reversible;  electrodes  can  frequently  be  placed  percutaneously  under  local  anesthesia  during  outpatient  surgery;  and,  unlike  more  invasive  surgical  approaches,  it  does  not  ablate  pain  pathways  or  alter  anatomy.6,7  Although  the  exact  mechanism  of  action  is  variously  described,  it  is  generally  held  that  pain  reduction  is  achieved  by  inhibiting  the  conduction  of  primary  neural  pathways  through  the  stimulation  of  large  nerve  fibers  that  override  the  transmission  of  smaller  nerve  fibers  more  directly  involved  in  pain  sensation.6,8-10