Efficacy of spinal cord stimulation for neuropathic pain: assessment by abstinence Monhemius R, Simpson BA, Eur J Pain 2003;7:513-9

Abstract Background Patients with spinal cord injury (SCI) frequently complain of intractable pain that is resistant to conservative treatments. Here, we report the successful application of 1-kHz high-frequency spinal cord stimulation (SCS) in a patient with refractory neuropathic pain secondary to SCI. Case presentation A 69-year-old male diagnosed with SCI (C4 American Spinal Injury Association Impairment Scale A) presented with severe at-level bilateral upper extremity neuropathic pain. Temporary improvement in his symptoms with a nerve block implied peripheral component involvement. The patient received SCS, and though the tip of the leads could not reach the cervical vertebrae, a 1-kHz frequency stimulus relieved the intractable pain. Conclusions SCI-related symptoms may include peripheral components; SCS may have a considerable effect on intractable pain. Even when the SCS electrode lead cannot be positioned in the target area, 1-kHz high-frequency SCS may still produce positive effects.

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Burst Spinal Cord Stimulation

Neurosurgery ◽

10.1227/01.neu.0000368153.44883.b3 ◽

2010 ◽

Vol 66 (5) ◽

pp. 986-990 ◽

Cited By ~ 201

Author(s):

Dirk De Ridder ◽

Sven Vanneste ◽

Mark Plazier ◽

Elsa van der Loo ◽

Tomas Menovsky

Keyword(s):

Spinal Cord ◽

Neuropathic Pain ◽

Visual Analog Scale ◽

Spinal Cord Stimulation ◽

Short Form ◽

Burst Stimulation ◽

Analog Scale ◽

Tonic Stimulation ◽

Better Than

Abstract INTRODUCTION Spinal cord stimulation is commonly used for neuropathic pain modulation. The major side effect is the onset of paresthesia. The authors describe a new stimulation design that suppresses pain as well as, or even better than, the currently used stimulation, but without creating paresthesia. METHODS A spinal cord electrode (Lamitrode) for neuropathic pain was implanted in 12 patients via laminectomy: 4 at the C2 level and 7 at the T8–T9 level for cervicobrachialgia and lumboischialgia, respectively (1 at T11 at another center). During external stimulation, the patients received the classic tonic stimulation (40 or 50 Hz) and the new burst stimulation (40-Hz burst with 5 spikes at 500 Hz per burst). RESULTS Pain scores were measured using a visual analog scale and the McGill Short Form preoperatively and during tonic and burst stimulation. Paresthesia was scored as present or not present. Burst stimulation was significantly better for pain suppression, by both the visual analog scale score and the McGill Short Form score. Paresthesia was present in 92% of patients during tonic stimulation, and in only 17% during burst stimulation. Average follow-up was 20.5 months. CONCLUSION The authors present a new method of spinal cord stimulation using bursts that suppress neuropathic pain without the mandatory paresthesia. Pain suppression seems as good as or potentially better than that achieved with the currently used stimulation. Average follow-up after nearly 2 years (20.5 months) suggests that this stimulation design is stable.

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Mechanisms of spinal cord stimulation in neuropathic pain

Neurological Research ◽

10.1080/01616412.2000.11740672 ◽

2000 ◽

Vol 22 (3) ◽

pp. 285-292 ◽

Cited By ~ 116

Author(s):

B.A. Meyerson ◽

B. Linderoth

Keyword(s):

Spinal Cord ◽

Neuropathic Pain ◽

Spinal Cord Stimulation

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First experience with chronic epidural spinal cord stimulation in Khanty-Mansi autonomous okrug — clinical observations

Neurology Bulletin ◽

10.17816/nb70921 ◽

2021 ◽

Vol LIII (2) ◽

pp. 94-100

Author(s):

Olga A. Bondarenko ◽

Gaspar V. Gavrilov ◽

Vadim A. Padurets ◽

Roman V. Kasich

Keyword(s):

Spinal Cord ◽

Neuropathic Pain ◽

Spinal Cord Stimulation ◽

Pain Syndrome ◽

Chronic Neuropathic Pain ◽

Neuropathic Pain Syndrome ◽

Epidural Stimulation ◽

Cord Injury ◽

Epidural Spinal Cord Stimulation ◽

And Migration

Purpose of the work. The article is devoted to the first experience of epidural stimulation in the Khanty-Mansiysk Autonomous Okrug at the budgetary institution Surgut Clinical Trauma Hospital. Clinical examples are presented for two main indications for the application of this technique (disease of the operated spine, a consequence of spinal cord injury in combination with chronic neuropathic pain syndrome). Research methods. An assessment of the intensity of pain syndrome was given according to a visual analogue scale, the Pain Detect questionnaire; indicators of anxiety, depression on the HADS scale; quality of life according to the Oswestry questionnaire for a follow-up period of 6-12 months in patients with chronic epidural stimulation. Results. A positive assessment of the action during test neurostimulation was 63.3% (38 patients). Of the established permanent systems, a good result was achieved and persisted for 12 months or more in 96% (24 patients). It was necessary to change the stimulation parameters in 13% (3 patients). Revision of permanent systems was performed in 20% (5 patients), due to the progression of the degenerative-dystrophic process of the spine, damage and migration of system elements. Conclusions. Chronic epidural spinal cord stimulation has established itself as a personalized, highly effective, minimally invasive and safe method of treating chronic neuropathic pain syndromes. Multicomponent corrective action is of scientific interest and requires further study.

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