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Brain Sci. 2018, 8(8), 138; https://doi.org/10.3390/brainsci8080138

Spinal Cord Stimulation for Neuropathic Pain: Current Trends and Future Applications

Neurosurgery Department, Functional Neurosurgery, Unit for the Surgical Treatment of Pain and Spasticity, Fondazione Istituto Neurologico Carlo Besta, 20131 Milan, Italy
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Received: 30 June 2018 / Accepted: 18 July 2018 / Published: 24 July 2018
(This article belongs to the Special Issue Neuromodulation for Intractable Pain)
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Abstract

The origin and the neural pathways involved in chronic neuropathic pain are still not extensively understood. For this reason, despite the wide variety of pain medications available on the market, neuropathic pain is challenging to treat. The present therapeutic alternative considered as the gold standard for many kinds of chronic neuropathic pain is epidural spinal cord stimulation (SCS). Despite its proved efficacy, the favourable cost-effectiveness when compared to the long-term use of poorly effective drugs and the expanding array of indications and technical improvements, SCS is still worldwide largely neglected by general practitioners, neurologists, neurosurgeons and pain therapists, often bringing to a large delay in considering as a therapeutic option for patients affected by neuropathic chronic pain. The present state of the art of SCS in the treatment of chronic neuropathic pain is here overviewed and speculations on whether to use a trial period or direct implant, to choose between percutaneous leads or paddle electrodes and on the pros and cons of the different patterns of stimulation presently available on the market (tonic stim, high-frequency stim and burst stim) are described. View Full-Text
Keywords: spinal cord stimulation (SCS); neuromodulation; neuropathic pain spinal cord stimulation (SCS); neuromodulation; neuropathic pain
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Dones, I.; Levi, V. Spinal Cord Stimulation for Neuropathic Pain: Current Trends and Future Applications. Brain Sci. 2018, 8, 138.

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