![]() They showed that dorsal column stimulation, as well as stimulation of the anterior spinocerebellar tract, inhibited paw withdrawal after painful stimuli in cats. Shealy et al employed SCS in 1967 for the first time in an animal model, using a technique that they termed dorsal column stimulation at that time. According to their theory, activation of myelinated Aβ fibers inhibits pain transmission and is enhanced by activation of thinly myelinated Aδ fibers and unmyelinated C fibers. Here, many peripheral neurons converge to a single neuron termed the wide dynamic range neuron. 5 They stated that external and internal pain stimuli are recorded by pain receptors in the skin, muscles, joints, and internal organs and switched to the second neuron of the pain pathway within the dorsal horn of the spinal cord. The development of SCS was one of the consequences of the gate control theory of Melzack and Wall. Outline of the history of SCS and its uses This review gives an overview of the present practice of SCS for chronic neuropathic pain and current developments in the field. Today, neurostimulation systems are used not only in the therapy of chronic pain but also in a multitude of different disorders, such as epilepsy, psychiatric diseases, and movement disorders, as well as gastrointestinal and urological diseases. Neuromodulation has undergone rapid development in the last few years. SCS for the treatment of pain must be seen in the general context of neuromodulative therapies. Stimulation patterns can now be adjusted according to the patient’s needs, thus increasing the efficacy of stimulation. In the last 10–15 years, SCS has undergone constant technical advancement. Nonetheless, there is still a significant underuse of this treatment. 3, 4 It was described for the first time in 1967 and has become a standard therapy in many hospitals since the middle of the 1980s. Spinal cord stimulation (SCS) constitutes a therapy alternative that, to date, remains underused. 1 Moreover, analgetic medication often has an insufficient effect on neuropathic pain. Patients with neuropathic pain usually are more heavily burdened than patients with nociceptive pain and suffer more often from insomnia, anxiety, and depression. The International Association for the Study of Pain defines neuropathic pain as pain caused by a lesion or disease of the somatosensory nervous system. Neuropathic pain constitutes a significant portion of chronic pain. ![]()
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