Spinal Cord Stimulation: Difference between revisions
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Revision as of 20:29, 29 February 2024
Original Editor - Sehriban Ozmen
Top Contributors - Sehriban Ozmen
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Description[edit | edit source]
Spinal cord stimulation (SCS) is a surgical treatment involving implantation of a device that applies electric impulses to the spinal cord. Based on the gate control theory of pain, the first device for SCS was introduced in 1968. [1]
Stimulation Paradigms[edit | edit source]
Tonic / Conventional Stimulation[edit | edit source]
- Generates paraesthesia in the target area. [2]
- Frequency: 35-80 Hz
- Pulse width: 200-450 μs
- Amplitude: 5-6 mA
Burst Stimulation[edit | edit source]
- Also known as paraesthesia-free stimulation. [1]
- Activates some brain areas, including the dorsal anterior cingulate and the dorsolateral precentral cortex.
- Low frequencies (40 Hz) with 5 closely spaced pulses (1 ms) at 500 Hz per burst, or 3 pulses at 100 Hz, followed by a repolarisation phase.
- Compared to tonic stimulation, provides a lower charge per pulse and, at the same time, a higher charge per second. The higher charge per second modulates the neurons involved in pain transmission.
- Provides greater pain relief over tonic stimulation in multiple studies. [3]
High Frequency Stimulation[edit | edit source]
- Frequency: 10 000 Hz
- Pulse width: 30 ms
- Low amplitude (approximately 2-3 A)
- The advantages over tonic stimulation are still controversial, although it is clear that the absence of paraesthesia may make it more comfortable.
Indications[edit | edit source]
Indications For Pain Management[edit | edit source]
- Failed back surgery syndrome, radiculopathy, and lumbago
- Complex regional pain syndrome
- Diabetic neuropathy and other neuropathies
- Phantom limb pain
- Angina pectoris and peripheral vascular disease
- Neuropathic pain secondary to tumour [1]
Non-Pain-Related Indications[edit | edit source]
- Parkinson’s disease and other movement disorders
- Spasticity
- Spinal trauma rehabilitation [1]
Physiotherapy Relevance[edit | edit source]
Resources[edit | edit source]
Percutaneous Electrical Nerve Stimulation
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Pérez JT. Spinal cord stimulation: beyond pain management. Neurología (English Edition). 2022 Sep 1;37(7):586-95.
- ↑ Miller JP, Eldabe S, Buchser E, Johanek LM, Guan Y, Linderoth B. Parameters of spinal cord stimulation and their role in electrical charge delivery: a review. Neuromodulation: Technology at the Neural Interface. 2016 Jun 1;19(4):373-84.
- ↑ Kirketeig T, Schultheis C, Zuidema X, Hunter CW, Deer T. Burst spinal cord stimulation: a clinical review. Pain Medicine. 2019 Jun 1;20(Supplement_1):S31-40.
