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Chapter-139 Spinal Cord Stimulation

BOOK TITLE: Ramamurthy's Decision Making in Pain Management: An Algorithmic Approach

Author
1. Associate Clinical Professor, Department of Medicine University of California, Los Angeles, CA, USA
2. EK Pang
ISBN
9789386261458
DOI
10.5005/jp/books/14128_140
Edition
3/e
Publishing Year
2018
Pages
3
Author Affiliations
2. UCLA/VA Greater Los Angeles, Healthcare System, Los Angeles, CA, USA
Chapter keywords
Spinal cord stimulation, SCS, complex regional pain syndrome, CRPS, radiofrequency, RF, implanted pulse generator, IPG

Abstract

Spinal cord stimulation (SCS) is a reversible adjunctive treatment for chronic neuropathic pain. Successful SCS implantation can assist in decreasing pain, reducing medication use, and increasing function. The exact mechanism of SCS is unclear. SCS gives a direct stimulation of the large sensory fibers in the dorsal columns “closing the gate” and preventing the smaller pain fibers from entering the dorsal horn. The full mechanism of action is likely more complex, with proposed mechanisms including neurochemical changes that reduce dorsal horn neuronal hyperexcitability, supraspinal effects, and sympathetic effects (peripheral vasodilation).

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