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Spinal cord stimulation in chronic pain: technical advances

Korean Journal of Pain 2020년 33권 2호 p.99 ~ 107
 ( Isagulyan Emil ) - Federal State Autonomous Institution Department of Functional Neurosurgery

 ( Slavin Konstantin ) - University of Illinois at Chicago Department of Neurosurgery
 ( Konovalov Nikolay ) - Federal State Autonomous Institution Department of Spinal Surgery
 ( Dorochov Eugeny ) - Federal State Autonomous Institution Department of Functional Neurosurgery
 ( Tomsky Alexey ) - Federal State Autonomous Institution Department of Functional Neurosurgery
 ( Dekopov Andrey ) - Federal State Autonomous Institution Department of Functional Neurosurgery
 ( Makashova Elizaveta ) - I.M. Sechenov First Moscow State Medical University Departament of Neurology
 ( Isagulyan David ) - I.M. Sechenov First Moscow State Medical University Departament of Clinical Science
 ( Genov Pavel ) - Moscow City Clinical Hospital Pain Management Clinic

Abstract


Chronic severe pain results in a detrimental effect on the patient’s quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

키워드

Chronic Pain; Complex Regional Pain Syndromes; Failed Back Surgery Syndrome; Low Back Pain; Neck Pain; Neuralgia; Pain; Pain Management; Spinal Cord Stimulation
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