Management of chronic limb pain with spinal cord stimulation.
BACKGROUND
Spinal Cord Stimulation (SCS) is a treatment option for chronic pain patients. The most common indication for SCS is the failed back syndrome with leg pain. In the last decade, advances in our understanding of appropriate stimulation programming, lead placement and the physiology of SCS, have led to changes in multi-site stimulation, and stimulation with differing programs. In the past, low back, axial neuropathic type pain was not responsive to SCS. With dual electrode arrays, and dual stimulation with alternating programs of stimulation, steering of stimulation paresthesia, and versatile programmable stimulation parameters, SCS has become a more versatile form of analgesia.


OBJECTIVE
To describe the current treatment rational for SCS and the results of that treatment.


RESULTS
The SCS is most efficient in patients with neuropathic pain of the extremities and less efficacious in patients with axial pain.


CONCLUSIONS
SCS is the most effective treatment for limb pain not amenable to surgical decompression. The success of SCS in this chronic pain group is 80% successful in treatment of leg pain, and much less effective in treatment of axial pain.
Fogel
Guy R
GR
Brodsky Chair of Spinal Surgery, Baylor College of Medcine, Houston, Texas 77030, USA.
Esses
Stephen I
SI
Calvillo
Octavio
O