title: [Epidural spinal cord stimulation for therapy of chronic pain. Summary of the S3 guidelines].
abstract: Epidural spinal cord stimulation (SCS) is a reversible but invasive procedure which should be used for neuropathic pain, e.g. complex regional pain syndrome I (CRPS) and for mostly chronic radiculopathy in connection with failed back surgery syndrome following unsuccessful conservative therapy. Epidural SCS can also successfully be used after exclusion of curative procedures and conservative therapy attempts for vascular-linked pain, such as in peripheral arterial occlusive disease stages II and III according to Fontaine and refractory angina pectoris. Clinical practice has shown which clinical symptoms cannot be successfully treated by epidural SCS, e.g. pain in complete paraplegia syndrome or atrophy/injury of the sensory pathways of the spinal cord or cancer pain. A decisive factor is a critical patient selection as well as the diagnosis. Epidural SCS should always be used within an interdisciplinary multimodal therapy concept. Implementation should only be carried out in experienced therapy centers which are in a position to deal with potential complications.
authors.affiliation: Neurochirurgische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Deutschland. volker.tronnier@uk-sh.de
authors.forename: V
authors.initials: V
authors.lastname: Tronnier
authors.forename: R
authors.initials: R
authors.lastname: Baron
authors.forename: F
authors.initials: F
authors.lastname: Birklein
authors.forename: S
authors.initials: S
authors.lastname: Eckert
authors.forename: H
authors.initials: H
authors.lastname: Harke
authors.forename: D
authors.initials: D
authors.lastname: Horstkotte
authors.forename: P
authors.initials: P
authors.lastname: Hügler
authors.forename: M
authors.initials: M
authors.lastname: Hüppe
authors.forename: B
authors.initials: B
authors.lastname: Kniesel
authors.forename: C
authors.initials: C
authors.lastname: Maier
authors.forename: G
authors.initials: G
authors.lastname: Schütze
authors.forename: R
authors.initials: R
authors.lastname: Thoma
authors.forename: R D
authors.initials: RD
authors.lastname: Treede
authors.forename: V
authors.initials: V
authors.lastname: Vadokas
mesh_terms: D000787:Angina Pectoris / Q000503:physiopathology / Q000628:therapy; D059350:Chronic Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D020918:Complex Regional Pain Syndromes / Q000503:physiopathology / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D004824:Epidural Space; D019317:Evidence-Based Medicine; D055111:Failed Back Surgery Syndrome / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011843:Radiculopathy / Q000503:physiopathology / Q000628:therapy; D013116:Spinal Cord / Q000503:physiopathology*