Neuromodulation: Spinal cord and peripheral nerve stimulation

Abstract

Spinal cord and peripheral nerve stimulation for relief of chronic intractable pain have been used since the mid-1960s. Multiple mechanisms of action have been theorized without a clear-cut winner. The early frustrations with patient selection criteria and equipment difficulties have diminished secondary to carefully controlled studies and improvements in equipment designs. Efficacy studies consistently show an overall 50% improvement in long-term pain control in patients who have failed conservative or other invasive modalities. With improvements in today's technology, one hopes that better analgesia will be attainable.

Peripheral median nerve stimulation for the treatment of iatrogenic complex regional pain syndrome (CRPS) type II after carpal tunnel surgery

“…[6][7][8] Spinal cord stimulation (SCS) is a well-established treatment, even if the results are controversial, in particular for CRPS type II. SCS does not produce a durable and statistically significant improvement in the pain from chronic CRPS-I.…”

Peripheral Nerve Stimulation: A Percutaneous Minimally Invasive Approach

“…Literature reports different experiences and varying outcomes of spinal cord stimulation (1), intrathecal infusion (2), and PNS for the treatment of complex regional pain syndrome type 2 (3–7). Weiner and Reed (8) and Buschmann and Oppel (9) have reported on the use of PNS via a percutaneous approach.…”

Challenges of Peripheral Nerve Stimulator Implantation in a Patient with New Onset Thrombocytopenia

“…The early frustrations with patient selection criteria and equipment difficulties have diminished secondary to carefully controlled studies and improvements in equipment designs. Efficacy studies consistently show an overall 50% improvement in long-term pain control in patients who have failed conservative or other invasive modalities [6].…”