Abstract

Spinal cord stimulation (SCS) is based on the gate control theory of pain, which states that the “gate” in the dorsal horn of the spinal cord regulates signal transduction from the spinal cord to the brain. Therefore, stimulating both Aß fibers and C fibers closes the gate, which results in masking pain transmission signals, a core feature of the mechanism of action of SCS. The spinal cord stimulator consists of leads placed in the epidural space along the dorsal column and is connected to an implantable pulse generator (IPG). The anatomical location of these leads plays a critical role in optimizing pain relief for the patient. This chapter reviews in step-by-step detail the methodology of placing SCS trial leads in a patient.

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