The application of spinal cord stimulation to treat refractory pain

Abstract

Background Refractory pain is a chronic disease that is not responsive to conventional medications and physical therapy. Spinal cord stimulation (SCS) has been recently employed to treat refractory pain, and its efficacy and safety have been verified. Objective This article aims to review the clinical application of SCS in the treatment of refractory pain. Content The electrode for SCS is inserted into epidural space to stimulate spinal dorsal fasciculus and sensory neurons. The overall effect of SCS is blocking pain signal transduction probably by enhancing the release of γ-aminobutyric acid, but inhibiting the release of glutamate in the spinal cord dorsal horn. Refractory pain has been reported in failed back surgery syndrome, complex regional pain syndromes, painful diabetic peripheral neuropathy, and postherpetic neuralgia. In 80% of patients with refractory pain, SCS shows therapeutic efficacy much better than conventional treatments, and improves sleeping, as well. Trend SCS is a safe and effective method for the treatment of refractory pain. Key words: Refractory pain; Spinal cord electrical stimulation