Dorsal column stimulation3/31/2024 ![]() ![]() The wash-in effect of DRGS and SCS was similar, but DRGS showed a faster washout course. We conclude that conventional DRGS is as effective as SCS in reduction of PDPN-associated mechanical hypersensitivity in STZ-induced diabetic rats. After cessation of stimulation (t = 60), the return of the log 10 (10 000 × 50% WT) response was significantly faster with DRGS than that of SCS (P < 0.05). Both DRGS and SCS induced a similar and complete reversal of mechanical hypersensitivity. The results of the experiments on these animals were compared to the results of a previous study using exactly the same model on PDPN animals selected for SCS (n = 8) (40-50 Hz, 0.19 ± 0.01 mA) and sham-SCS (n = 3). Mechanical paw withdrawal thresholds (WT, measured in grams) in response to DRGS (50 Hz, 0.18 ± 0.05 mA) were assessed with von Frey testing. Rats were assigned to DRGS (n = 11) or sham-DRGS (n = 7). Rats with a significant decrease in mechanical paw withdrawal response to von Frey filaments 4 weeks after injection were implanted with DRGS electrodes (n = 18). As in painful diabetic polyneuropathy (PDPN) pain is mostly present in the feet, we hypothesized that DRGS is more effective in relieving pain in PDPN when compared to SCS.ĭiabetes was induced in female Sprague-Dawley rats with an intraperitoneal injection of 65 mg/kg of streptozotocin (STZ n = 48). Undoubtedly, this proper selection and a better knowledge of its underlying mechanisms of action, will allow this cutting edge technique to be more acceptable among pain physicians.įailed back surgery syndrome indications neuromodulation review spinal cord stimulation.Conventional dorsal root ganglion stimulation (DRGS) is known to achieve better pain-paresthesia overlap of difficult-to-reach areas like the feet compared to dorsal column spinal cord stimulation (SCS). Spinal cord stimulation is a useful tool for neuromodulation, if an accurate patient selection is carried out prior, which should include a trial period. Further indications may be phantom limb pain, chronic intractable pain located in the head, face, neck, or upper extremities, spinal lumbar stenosis in patients who are not surgical candidates, and others. Also, this technique is useful in patients with refractory angina and critical limb ischemia, in whom surgical or endovascular treatment cannot be performed. ![]() Failed back surgery syndrome (FBSS) is the most common indication for SCS, whereas, the complex regional pain syndrome (CRPS) is the second one. At present, the indications of SCS are being revised constantly, while new applications are being proposed and researched worldwide. The mechanism of action of SCS would be based on the antidromic activation of the dorsal column fibers, which activate the inhibitory interneurons within the dorsal horn. In spite of the existence of several studies that try to prove the mechanism of action of SCS, it still remains unknown. This article is a non-systematic review of the mechanism of action, indications, results, programming parameters, complications, and cost-effectiveness of SCS. Following that, technological progress, among other advances, helped SCS become an effective tool to reduce pain. Spinal cord stimulation (SCS) has been used to treat neuropathic pain since 1967.
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