Abstract
Spinal cord stimulators (SCS) have been gaining momentum in the last decade as their role in the management of chronic pain has become more apparent. Our intention was to search, analyze and highlight the effects of spinal cord stimulators on end-organ perfusion. We also looked at vascular diseases of atherosclerotic and nonatherosclerotic nature by examining objective evidence of improved circulation, pain control, limb salvage, and quality of life. We paid specific attention to disease processes such as cerebral hypoperfusion, Chronic-Critical Limb Ischemia, Intractable Angina Pectoris (IAP), Raynaud’s syndrome and Thromboangiitis Obliterans.We performed a Medline database search for medical literature relevant to Spinal cord stimulators encompassing the years 1950 to 2019. Search terms included “Spinal cord stimulator,” plus one of the following search terms: vasculopathy, stroke, cerebral blood flow, angina pectoris, diabetic ulcers, chronic critical leg ischemia, thromboangiitis obliterans and peripheral vascular disease. We included both clinical and experimental human studies that investigated the effect of SCS’s on end-organ perfusion. We also investigated the pathophysiological mechanism of action of SCS’s on the vasculature. We found 497 articles of which 43 more relevant and impactful articles investigating the hemodynamic effects of SCS and its possible mechanism were selected. Animal studies were excluded from the literature review as they provided heterogeneity. In addition to reporting literature supporting the use of stimulators for currently FDA approved uses, we also actively looked for potential future uses. Spinal Cord stimulators showed improvement in cerebral blood flow, increased capillary recruitment, and better quality of life in many studies. Patients also had increased exercise capacity and a significant reduction in the use of narcotic drug use and daily anginal attacks in patients suffering from IAP.
Highlights
BackgroundSpinal cord stimulators (SCS) have been gaining more attention in recent years for their ability to help control pain
Spinal cord stimulation (SCS)’s have an already established role in patients suffering from chronic pain and have potential in healing vasculopathies
We believe SCS have a place as an alternative and nonsurgical treatment for many vasculopathies; while we realize that SCS may not be applicable to everyone, SCS definitely has a niche in a subset of patients on the later more severe side of end stage vasculopathy in which small changes in microperfusion can help immensely
Summary
Spinal cord stimulators (SCS) have been gaining more attention in recent years for their ability to help control pain. The Cochrane review entailing studies prior to the year 2003 did not investigate mortality; it shed light on the improvement of limb salvage rates and better pain control [25,31] Another meta-analysis in 2015 aimed at NR-CCLI examined mortality and risk of amputation in 19 studies enrolling 2779 patients found no significant effect on mortality in the groups, but did find a decreased risk of amputation in intermittent pneumatic compression and SCS groups [31].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
