Spinal cord stimulation for neuropathic pain: current perspectives

Tilman Wolter, Tilman Wolter

Abstract

Neuropathic pain constitutes a significant portion of chronic pain. Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain. Spinal cord stimulation constitutes a therapy alternative that, to date, remains underused. In the last 10 to 15 years, it has undergone constant technical advancement. This review gives an overview of the present practice of spinal cord stimulation for chronic neuropathic pain and current developments such as high-frequency stimulation and peripheral nerve field stimulation.

Keywords: neuropathic pain; neurostimulation; spinal cord stimulation.

Figures

Figure 1
Figure 1
Flow chart of spinal cord stimulation procedure.
Figure 2
Figure 2
Anteroposterior and lateral view of a thoracolumbar spinal cord stimulation placement; the 8-pole lead (octrode) is positioned at level TH10–12, and the impulse generator is placed abdominally subcutaneously. Abbreviations: R, right; L, left.
Figure 3
Figure 3
Anteroposterior and lateral view of a cervical spinal cord stimulation placement; the 8-pole lead (octrode) is positioned at level C3-5, and the spinal canal is entered at level TH2/3. Abbreviation: R, right.

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