Spinal Cord Stimulation for Chronic Pain Management

This article reviews the current knowledge and clinical applications of spinal cord stimulation for chronic pain management. It also covers basic neurophysiology, implantation techniques, indications, and complications.

Chronic pain - spinal cord stimulation - neurostimulation - neuromodulation

REFERENCES

• 1 Dioscorides .The Greek Herbal of Dioscorides. Gunther Robert (transl). Oxford: University Press 1934
• 2 Galen C. De Usu Partium. Translated from the Greek with an introduction and commentary by Margaret Tallmadge May. Ithaca, NY; Cornell University Press 1968
• 3 Kellaway P. The part played by electric fish in the early history of bioelectricity and electrotherapy.  Bull Hist Med. 1946;  20 112-137
• 4 Stillings D. A survey of the history of electrical stimulation for pain to 1900.  Med Instrum. 1975;  9 255-259
• 5 Schiller F. The history of algology, algotherapy, and the role of inhibition.  Hist Philos Life Sci. 1990;  12 27-50
• 6 Kane K, Taub A. A history of local electrical analgesia.  Pain. 1975;  1 125-138
• 7 Melzack R, Wall P D. Pain mechanisms: a new theory.  Science. 1965;  150 971-979
• 8 Shealy C N, Cady R K. Historical Perspective of Pain Management. 5th ed. Boca Raton, FL; St. Lucie Press 1998
• 9 Shealy C N, Mortimer J T, Reswick J B. Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report.  Anesth Analg. 1967;  46 489-491
• 10 Hoppenstein R. Electrical stimulation of the ventral and dorsal columns of the spinal cord for relief of chronic intractable pain.  Surg Neurol. 1975;  4 187-194
• 11 Larson S J, Sances A, Cusick J F et al.. A comparison between anterior and posterior implant systems.  Surg Neurol. 1975;  4 180-186
• 12 Lazorthes Y, Verdie J CL, Arbus L. Stimulation analgésique médullaire antérieure et postérieure par technique d'implantation percutanée.  Acta Neurochir (Wien). 1978;  40 253-276
• 13 Dooley D M. Percutaneous electrical stimulation of the spinal cord. Bal Harbour, FL; Bal Harbour 1975
• 14 Waltz J M. Computerized percutaneous multi-level spinal cord stimulation in motor disorders.  Appl Neurophysiol. 1982;  45 73-92
• 15 Sin W K, Coburn B. Electrical stimulation of the spinal cord: a further analysis relating to anatomic factors and tissue properties.  Med Biol Eng Comput. 1983;  21 264-269
• 16 Struijk J J, Holsheimer J, van der Heide G G et al.. Recruitment of dorsal column fibers in spinal cord stimulation: influence of collateral branching. IEEE Trans Biomed Eng 1992 39: 903-912
• 17 Struijk J J, Holsheimer J, van Veen B K et al.. Epidural spinal cord stimulation: calculation of field potentials with special reference to dorsal column nerve fibers.  IEEE Trans Biomed Eng. 1991;  38 104-110
• 18 Holsheimer J, Struijk J J. How do geometric factors influence epidural spinal cord stimulation? A quantitative analysis by computer modeling.  Stereotact Funct Neurosurg. 1991;  56 234-249
• 19 Struijk J J, Holsheimer J, Barolat G et al.. Paresthesia thresholds is spinal cord stimulation: a comparison of theoretical results with clinical data.  IEEE Trans Rehabil Eng. 1993;  1 101-108
• 20 Dubuisson D. Effect of dorsal-column stimulation on gelatinosa and marginal neurons of cat spinal cord.  J Neurosurg. 1989;  70 257-265
• 21 Rees H, Roberts M H. Antinociceptive effects of dorsal column stimulation in the rat: involvement of the anterior pretectal nucleus.  J Physiol. 1989;  417 375-388
• 22 Linderoth B, Gazelius B, Franck J et al.. Dorsal column stimulation induces release of serotonin and substance P in the cat dorsal horn.  Neurosurgery. 1992;  31 289-297
• 23 Linderoth B. Dorsal Column Stimulation and Pain: Experimental Studies of Putative Neurochemical and Neurophysiological Mechanisms. Stockholm: Kongl Carolinska Medico Chirurgiska Institutet 1992
• 24 Linderoth B, Stiller C, Gunasekera L et al.. Gamma-aminobutyric acid is released in the dorsal horn by electrical spinal cord stimulation: an in vivo microdialysis study in the rat.  Neurosurgery. 1994;  34 484-489
• 25 Davidoff R A. Handbook of the Spinal Cord. Vols 2 and 3. New York; Marcel Dekker 1984
• 26 Carpenter M B. Human Neuroanatomy. Baltimore; Williams & Wilkins 1976
• 27 Martin J H, Jessell T M. Anatomy of the Somatic Sensory System. 3rd ed. New York; Elsevier 1991
• 28 Tulgar M, Barolat G, Ketcik B. Analysis of parameters for epidural spinal cord stimulation. 1. Perception and tolerance thresholds resulting from 1,100 combinations.  Stereotact Funct Neurosurg. 1993;  61 129-139
• 29 Tulgar M, Barolat G, Ketcik B. Analysis of parameters for epidural spinal cord stimulation. 2. Usage ranges resulting from 3,000 combinations.  Stereotact Funct Neurosurg. 1993;  61 140-145
• 30 Tulgar M, He J, Barolat G et al.. Analysis of parameters for epidural spinal cord stimulation. 3. Topographical distribution of paresthesiae.  Stereotact Funct Neurosurg. 1993;  61 146-155
• 31 Barolat G, Zeme S, Ketcik B. Multifactorial analysis of epidural spinal cord stimulation.  Stereotact Funct Neurosurg. 1991;  56 77-103
• 32 Barolat G, Schwartzman R, Woo R. Epidural spinal cord stimulation in the management of reflex sympathetic dystrophy.  Stereotact Funct Neurosurg. 1989;  53 29-39
• 33 Villavicencio A T, Leveque J C, Rubin L, Bulsara K, Gorecki J P. Laminectomy versus percutaneous electrode placement for spinal cord stimulation.  Neurosurgery. 2000;  46 399-405
• 34 North R, Kidd D H, Olin J et al.. Spinal cord stimulation electrode design: a prospective randomized comparison of percutaneous and insulated paddle electrodes. Abstracts of the 4th International Congress of the INS 1998: 211
• 35 Holsheimer J, Nuttin B, King G et al.. Clinical evaluation of paresthesia steering with a new system for spinal cord stimulation.  Neurosurgery. 1998;  42 541-549
• 36 Alo K, Poli P, Ghiara M et al.. The treatment of refractory reflex sympathetic dystrophy with higher frequency tripolar dual octrode spinal cord stimulation: a case report. Abstracts of the 4th International Congress of the INS 1998: 282
• 37 Barolat G. Experience with 509 plate electrodes implanted epidurally from C1 to L1.  Stereotact Funct Neurosurg. 1993;  61 60-79
• 38 Iacono R P, Boswell M V, Guthkelch A N. Placement of spinal cord stimulators using spinal anaesthesia and monitored by cortical evoked potentials obtained from spinal cord stimulation.  Pain. 1990;  5 S234
• 39 Alo K M, Yland M J, Redko V et al.. Lumbar and sacral nerve root stimulation in the treatment of chronic pain: a novel anatomic approach and neurostimulation technique.  Neuromodulation. 1999;  2 23-31
• 40 Barolat G, Massaro G, He J et al.. Mapping of sensory responses to epidural stimulation of the intraspinal neural structures in man.  J Neurosurg. 1993;  78 233-239
• 41 Law J. Spinal stimulation: statistical superiority of monophasic stimulation of narrowly separated, longitudinal bipoles having rostral cathodes.  Appl Neurophysiol. 1983;  46 129-137
• 42 Barolat G, Ketcik B. Percutaneous stimulation of the lumbo-sacral plexus.  Stereotact Funct Neurosurg. 1991;  56 250-257
• 43 Law J D. A new method for targeting a spinal stimulator: quantitatively paired comparisons.  Appl Neurophysiol. 1987;  50 436
• 44 Krainick J U, Thoden U, Riechert T. Pain reduction in amputees by long-term spinal cord stimulation: long-term follow-up study over 5 years.  J Neurosurg. 1980;  52 346-350
• 45 North R B, Ewend M G, Lawon M T et al.. Spinal cord stimulation for chronic intractable pain: superiority of multichannel devices.  Pain. 1991;  44 119-130
• 46 North R B, Fowler K R, Nigrin D A et al.. Automated ‘pain drawing’ analysis by computer-controlled, patient-interactive neurological stimulation system.  Pain. 1992;  50 51-57
• 47 Kumar K, Toth C. Epidural spinal cord stimulation for treatment of chronic pain-some predictors of success. A 15-year experience.  Surg Neurol. 1998;  50 110-120
• 48 Lang P. The treatment of chronic pain by epidural spinal cord stimulation-a 15 year follow up; present status.  Axone. 1997;  18(4) 71-73
• 49 North R B, Kidd D H, Zahurak M et al.. Spinal cord stimulation for chronic, intractable pain: experience over two decades.  Neurosurgery. 1993;  32 384-394
• 50 Spiegelmann R, Friedman W A. Spinal cord stimulation: a contemporary series.  Neurosurgery. 1991;  28 65-71
• 51 Koeze T H, Williams A C, Reiman S. Spinal cord stimulation and the relief of chronic pain.  J Neurol Neurosurg Psychiatry. 1987;  50 1424-1429
• 52 Kavar B, Rosenfeld J V. The efficacy of spinal cord stimulation for chronic pain.  J Clin Neurosci. 2000;  7 409-413
• 53 Barolat G, Oakley J C, Law J D et al.. Epidural spinal cord stimulation with multiple electrode paddle lead is effective in treating intractable low back pain.  Neuromodulation. 2001;  4 59-66
• 54 Burchiel K J, Anderson V C, Brown F D et al.. Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain.  Spine. 1996;  21 2786-2794
• 55 North R B, Kidd D H, Piantadosi S. Spinal cord stimulation versus reoperation for failed back surgery syndrome: a prospective, randomized study design.  Acta Neurochir Suppl (Wien). 1995;  64 106-108
• 56 North R B, Kidd D H, Lee M S et al.. A prospective, randomized study of spinal cord stimulation versus reoperation for failed back surgery syndrome: initial results.  Stereotact Funct Neurosurg. 1994;  62 267-272
• 57 Carlsson A M. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analog scale.  Pain. 1993;  16 87-101
• 58 Fairbanks J C, Cooper J, Davies J B et al.. The Oswestry Low Back Pain disability questionnaire.  Physiotherapy. 1980;  66 271-272
• 59 Bergner M, Bobbit R A, Pollard W E et al.. The sickness impact profile: validation of a health status measure.  Med Care. 1976;  14 57-67
• 60 deBruin A F, Diederiks L P, deWitte L P et al.. The development of a short generic, version of the sickness impact profile.  J Clin Epidemiol. 1994;  47 407-418
• 61 Meglio M, Cioni B. Spinal cord stimulation in low back and leg pain.  Stereotact Funct Neurosurg. 1994;  62 263-266
• 62 De La Porte C V. Spinal cord stimulation in failed back surgery syndrome.  Pain. 1993;  52 55-61
• 63 LeDoux M S, Langford K H. Spinal cord stimulation for the failed back syndrome.  Spine. 1993;  18 191-194
• 64 Turner J A, Loeser J D, Bell K G. Spinal cord stimulation for chronic low back pain: a systematic literature synthesis.  Neurosurgery. 1995;  37 1088-1095
• 65 Bell G KK, Kidd D, North R B. Cost-effectiveness analysis of spinal cord stimulation in treatment of failed back surgery syndrome.  J Pain Symptom Manage. 1997;  13 286-295
• 66 Devulder J, De Laat M, Van Bastelaere M, Rolly G. Spinal cord stimulation: a valuable treatment for chronic failed back surgery patients.  J Pain Symptom Manage. 1997;  13 296-301
• 67 North R B, Ewend M G, Lawton M T et al.. Failed back surgery syndrome: 5-year follow-up after spinal cord stimulator implantation.  Neurosurgery. 1991;  28 692-699
• 68 Kemler M A, Barendse G A, van Kleef M. Pain relief in complex regional pain syndrome due to spinal cord stimulation does not depend on vasodilation.  Anesthesiology. 2000;  92 1653-1660
• 69 Kemler M A, Barendse G A, van Kleef M. Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy.  N Engl J Med. 2000;  343 618-624
• 70 Oakley J C, Weiner R L. Spinal cord stimulation for complex regional pain syndrome: a prospective study of 19 patients at two centers.  Neuromodulation. 1999;  2 47-50
• 71 Bennet D S, Alo K M, Oakley J et al.. Spinal cord stimulation for complex regional pain syndrome I [RSD]: a retrospective multicenter experience from 1995 to 1998 of 101 patients.  Neuromodulation. 1999;  2 202-210
• 72 Kemler M A, Barendse G A, van Kleef M. Electrical spinal cord stimulation in reflex sympathetic dystrophy: retrospective analysis of 23 patients.  J Neurosurg. 1999;  90(1 suppl) 79-83
• 73 Kumar K, Nath R K, Toth C. Spinal cord stimulation is effective in the management of reflex sympathetic dystrophy.  Neurosurgery. 1997;  40 503-509
• 74 Augustinsson L EL. Spinal cord electrical stimulation in severe angina pectoris: surgical technique, intraoperative physiology, complications, and side effects.  Pacing Clin Electrophysiol. 1989;  12 693-694
• 75 DeJongste M JL, Haaksma J, Hautvast R WM et al.. Effects of spinal cord stimulation on daily life myocardial ischemia in patients with severe coronary artery disease. A prospective ambulatory ECG study.  Br Heart J. 1994;  71 413-418
• 76 DeJongste M JL, Hautvast R WM, Hillege H L et al.. Efficacy of spinal cord stimulation as an adjuvant therapy of angina pectoris. A prospective randomized study.  J Am Coll Cardiol. 1994;  23 1592-1597
• 77 Mannheimer C, Augustinsson L E, Carlsson C A et al.. Epidural spinal electrical stimulation in severe angina pectoris.  Br Heart J. 1988;  59 56-61
• 78 Sanderson J E, Brooksby P, Waterhouse D et al.. Epidural spinal electrical stimulation for severe angina: a study of its effects on symptoms, exercise tolerance and degree of ischaemia.  Eur Heart J. 1992;  13 628-633
• 79 Thamer V, Deussen A, Schipke J D et al.. Pain and myocardial ischemia: the role of the sympathetic system.  Basic Res Cardiol. 1990;  85(suppl 1) 253-266
• 80 Meller S T, Gebhart G F. A critical review of the afferent pathways and the potential chemical mediators involved in cardiac pain.  Neuroscience. 1992;  48 501-524
• 81 Murphy D F, Giles K E. Dorsal column stimulation for pain relief from intractable angina pectoris.  Pain. 1987;  28 365-368
• 82 DeJongste M J. Spinal cord stimulation for ischemic heart disease.  Neurol Res. 2000;  22 293-298
• 83 Norrsell H, Pilhall M, Eliasson T, Mannheimer C. . Effects of spinal cord stimulation and coronary artery bypass grafting on myocardial ischemia and heart rate variability: further results from the ESBY study.  Cardiology. 2000;  94 12-18
• 84 Mannheimer C, Eliasson T, Augustinsson L E et al.. Electrical stimulation versus coronary artery bypass surgery in severe angina pectoris: the ESBY study.  Circulation. 1998;  97 1157-1163
• 85 Vulink N, Overgaauw D, Jesserun G et al.. The effects of spinal cord stimulation on quality of life in patients with therapeutically chronic refractory angina pectoris.  Neuromodulation. 1999;  2 33-40
• 86 Andersen C, Hole P, Oxhoj H. Will SCS treatment for angina pectoris pain conceal myocardial infarction?. Abstracts of the First Meeting of the International Neuromodulation Society, Rome 1992: 39
• 87 Cook A W, Weinstein S P. Chronic dorsal column stimulation in multiple sclerosis. Preliminary report.  N Y State J Med. 1973;  73 2868-2872
• 88 Cook A W, Oygar A, Baggenstos P et al.. Vascular disease of extremities. Electric stimulation of spinal cord and posterior roots.  N Y State J Med. 1976;  76 366-368
• 89 Meglio M, Cioni B, Dal Lago A et al.. Pain control and improvement of peripheral blood flow following epidural spinal cord stimulation: case report.  J Neurosurg. 1981;  54 821-823
• 90 Jacobs M J, Jorning P J, Joshi S R et al.. Epidural spinal cord electrical stimulation improves microvascular blood flow in severe limb ischemia.  Ann Surg. 1988;  207 179-183
• 91 Broseta J, Barbera J, de Vera J A et al.. Spinal cord stimulation in peripheral arterial disease. A cooperative study.  J Neurosurg. 1986;  64 71-80
• 92 Fiume D, Palombi M, Sciassa V. Spinal cord stimulation (SCS) in peripheral ischemic pain.  Pacing Clin Electrophysiol. 1989;  12 698-704
• 93 Galley D, Rettori R, Boccalon H. Electric stimulation of the spinal cord in arterial diseases of the legs. A multicenter study of 244 patients.  J Mal Vasc. 1992;  17 208-213
• 94 Horsch S, Claeys L. Epidural spinal cord stimulation in the treatment of severe peripheral arterial occlusive disease.  Ann Vasc Surg. 1994;  8 468-474
• 95 Jacobs M J, Jorning P J, Beckers R C et al.. Foot salvage and improvement of microvascular blood flow as a result of epidural spinal cord electrical stimulation.  J Vasc Surg. 1990;  12 354-360
• 96 Sampere C T, Guasch J A, Paladino C M. Spinal cord stimulation for severely ischemic limbs.  Pacing Clin Electrophysiol. 1989;  12 273-279
• 97 Robaina F JD, Dominguez M, Diaz M, Rodriguez J, deVera J. Spinal cord stimulation for relief of chronic pain in vasospastic disorders of the upper limbs.  Neurosurgery. 1989;  24 63-67
• 98 Meglio M, Cioni B, Prezioso A, Talamonti G. Spinal cord stimulation (SCS) in the treatment of postherpetic pain.  Acta Neurochir Suppl (Wien). 1989;  46 65-66
• 99 Tasker R R, DeCarvalho G T, Dolan E J. Intractable pain of spinal cord origin: clinical features and implications for surgery.  J Neurosurg. 1992;  77 373-378
• 100 Sharan A D, Harrop J E, Barolat G. Management of compressive symptoms caused by implanted spinal cord stimulation electrodes. Abstracts of the Congress of Neurological Surgeons, San Antonio, TX 2000
• 101 Meglio M, Cioni B, Rossi G F. Spinal cord stimulation in management of chronic pain: a 9-year experience.  J Neurosurg. 1989;  70 519-524
• 102 Reynolds A F, Shetter A G. Scarring around cervical epidural stimulating electrode.  Neurosurgery. 1983;  13 63-65
• 103 Brandwin M AK, Kewman D G. MMPI indicators of treatment response to spinal epidural stimulation in patients with chronic pain and patients with movement disorders.  Psychol Rep. 1982;  51 1059-1064
• 104 Kupers R C, Van den Oever R, Van Houdenhove B et al.. Spinal cord stimulation: a nation-wide survey on the incidence, indication, and therapeutic efficacy by health insurer.  Pain. 1994;  56 211-216
• 105 Nielson K D, Adams J E, Hosobuchi Y. Experience with dorsal column stimulation for relief of chronic intractable pain: 1968-1973.  Surg Neurol. 1975;  4 148-152
• 106 Monsalve V, de Andres J A, Valia J C. Application of a psychological decision algorithm for the selection of patients susceptible to implantation of neuromodulation systems for the treatment of chronic pain. A proposal.  Neuromodulation. 2000;  3 191-200
• 107 Olson K A, Bedder M D, Anderson V C et al.. Psychological variables associated with outcome of spinal cord stimulation trials.  Neuromodulation. 1998;  1 6-13
• 108 Burchiel K J, Anderson V C, Wilson B J et al.. Prognostic factors of spinal cord stimulation for chronic back and leg pain.  Neurosurgery. 1995;  36 1101-1110
• 109 Ruchinskas R, O'Grady T. Psychological variables predict decisions regarding implantation of a spinal cord stimulator.  Neuromodulation. 2000;  3 183-189
• 110 Daniel M SL, Long C, Hutcherson M et al.. Psychological factors and outcome of electrode implantation for chronic pain.  Neurosurgery. 1985;  17 773-777
• 111 North R B, Kidd D H, Wimberly R L et al.. Prognostic value of psychological testing in patients undergoing spinal cord stimulation: a prospective study.  Neurosurgery. 1996;  39 301-310
• 112 Erickson D L. Percutaneous trial of stimulation for patient selection for implantable stimulating devices.  J Neurosurg. 1975;  43 440-444
• 113 Feler C, Kaufman S. Spinal cord stimulation: one stage?.  Acta Neurochir (Wien). 1992;  117 91
• 114 Hosobuchi Y, Adams J E, Weinstein P R. Preliminary percutaneous dorsal column stimulation prior to permanent implantation. Technical note.  J Neurosurg. 1972;  37 242-245
• 115 Simpson B A. Spinal cord stimulation in 60 cases of intractable pain.  J Neurol Neurosurg Psychiatry. 1991;  54 196-199