Skip to main content
Log in

Evolving Spinal Cord Stimulation Technologies and Clinical Implications in Chronic Pain Management

  • Other Pain (A Kaye and N Vadivelu, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Spinal cord stimulation (SCS), based on the gate theory of nociception, has been shown to be effective in the management of chronic pain conditions. While early-generation technology offered many patients improvement in their pain and symptoms, limitations including paresthesia, dependence on mapping, decreased chronological efficacy, and inadequate coverage left many patients with persistent pain and overt therapeutic failure.

Recent Findings

New advances in neuromodulation technology circumvent many of these previous limitations and offer patients improved pain relief and quality of life.

Summary

In this review, an update on recent technological developments in the field of SCS and peripheral neuromodulation is presented with discussion on differentiating characteristics which may help guide applicability to individual patient needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Song JJ, Popescu A, Bell RL. Present and potential use of spinal cord stimulation to control chronic pain. Pain Physician. 2014;17:235–46.

    PubMed  Google Scholar 

  2. Epstein LJ, Palmieri M. Managing chronic pain with spinal cord stimulation. Mt Sinai J Med. 2012;79:123–32.

    Article  Google Scholar 

  3. Kapural L. Spinal cord stimulation for intractable chronic pain. Curr Pain Headache Rep. 2014;18:18–23.

    Article  Google Scholar 

  4. North RB, Ewend MG, Lawton MT, Piantadosi S. Spinal cord stimulation for chronic, intractable pain: superiority of multi-channel devices. Pain. 1991;44:119–30.

    Article  CAS  Google Scholar 

  5. Russo M, Van Buyten J-P. 10-kHz high-frequency SCS therapy: a clinical summary. Pain Med. Wiley-Blackwell. 2015;16:934–42.

    Article  Google Scholar 

  6. Barolat G, Massaro F, He J, Zeme S, Ketcik B. Mapping of sensory responses to epidural stimulation of the intraspinal neural structures in man. J Neurosurg. 1993;78:233–9.

    Article  CAS  Google Scholar 

  7. Dones I, Levi V. Spinal cord stimulation for neuropathic pain: current trends and future applications. Brain Sci. 2018;8.

    Article  Google Scholar 

  8. •• Deer T, Slavin KV, Amirdelfan K, North RB, Burton AW, Yearwood TL, et al. Success Using Neuromodulation With BURST (SUNBURST) study: results from a prospective, randomized controlled trial using a novel burst waveform. Neuromodulation. 2018;21:56–66 Results from the prospective RCT SUNBURST study on neuromodulation with burst waveform technology.

    Article  Google Scholar 

  9. Shurrab M, Kaoutskaia A, Baranchuk A, Lau C, Singarajah T, Lashevsky I, et al. Are there increased periprocedural complications with the MRI-conditional Medtronic Revo SureScan Pacing System?: A meta-analysis. Neth Heart J. 2018;26:233–9.

    Article  CAS  Google Scholar 

  10. De Carolis G, Paroli M, Tollapi L, Doust MW, Burgher AH, Yu C, et al. Paresthesia-independence: an assessment of technical factors related to 10 kHz paresthesia-free spinal cord stimulation. Pain Physician. 2017;20:331–41.

    PubMed  Google Scholar 

  11. Medtronic. Spinal cord stimulation systems - Intellis platform [Internet]. Hist. | Medtronic. 2018.

  12. Williamson BD, Gohn DC, Ramza BM, Singh B, Zhong Y, Li S, et al. Real-world evaluation of magnetic resonance imaging in patients with a magnetic resonance imaging conditional pacemaker system: results of 4-year prospective follow-up in 2,629 patients. JACC Clin Electrophysiol. 2017;3:1231–9.

    Article  Google Scholar 

  13. Schultz DM, Webster L, Kosek P, Dar U, Tan Y, Sun M. Sensor-driven position-adaptive spinal cord stimulation for chronic pain. Pain Physician. 2012;15:1–12.

    PubMed  Google Scholar 

  14. Goudman L, Smet I, Mariën P, De Jaeger M, De Groote S, Huysmans E, et al. Is the self-reporting of failed back surgery syndrome patients treated with spinal cord stimulation in line with objective measurements? Neuromodulation. 2018;21:93–100.

    Article  Google Scholar 

  15. •• Kapural L, Yu C, Doust MW, Gliner BE, Vallejo R, Sitzman BT, et al. Comparison of 10-kHz high-frequency and traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain. Neurosurgery. 2016;79:667–77 A RCT study with a 24-month follow-up comparing results of HF-10 therapy to traditional low-frequency SCS.

    Article  Google Scholar 

  16. Nevro Corp. Procedure benefits [Internet]. Nevro - about us - who we are. 2018.

  17. Kapural L, Yu C, Doust MW, Gliner BE, Vallejo R, Sitzman BT, et al. Novel 10-kHz high-frequency therapy (HF10 therapy) is superior to traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: the SENZA-RCT randomized controlled trial. Anesthesiology. 2015;123:851–60.

    Article  Google Scholar 

  18. Liem L. Stimulation of the dorsal root ganglion. Prog Neurol Surg. 2015;213–224.

  19. Kent AR, Min X, Hogan QH, Kramer JM. Mechanisms of dorsal root ganglion stimulation in pain suppression: a computational modeling analysis. Neuromodulation. 2018;21:234–46.

    Article  Google Scholar 

  20. Billet B, Hanssens K, De Coster O, Nagels W, Weiner RL, Wynendaele R, et al. Wireless high-frequency dorsal root ganglion stimulation for chronic low back pain: a pilot study. Acta Anaesthesiol Scand. 2018;62:1133–8.

    Article  CAS  Google Scholar 

  21. Eldabe S, Espinet A, Wahlstedt A, Kang P, Liem L, Patel NK, et al. Retrospective case series on the treatment of painful diabetic peripheral neuropathy with dorsal root ganglion stimulation. Neuromodulation. 2018;21:787–92.

    Article  Google Scholar 

  22. Morgalla MH, Bolat A, Fortunato M, Lepski G, Chander BS. Dorsal root ganglion stimulation used for the treatment of chronic neuropathic pain in the groin: a single-center study with long-term prospective results in 34 cases. Neuromodulation. 2017;20:753–60.

    Article  Google Scholar 

  23. Mol FMU, Roumen RM, Scheltinga MR. Comparing the efficacy of targeted spinal cord stimulation (SCS) of the dorsal root ganglion with conventional medical management (CMM) in patients with chronic post-surgical inguinal pain: the SMASHING trial. BMC Surg. 2018;18:18.

    Article  Google Scholar 

  24. Vuka I, Vučić K, Repić T, Ferhatović Hamzić L, Sapunar D, Puljak L. Electrical stimulation of dorsal root ganglion in the context of pain: a systematic review of in vitro and in vivo animal model studies. Neuromodulation. 2018;21:213–24.

    Article  Google Scholar 

  25. Xu J, Liu A, Cheng J. New advancements in spinal cord stimulation for chronic pain management. Curr Opin Anaesthesiol. 2017;30:710–7.

    Article  Google Scholar 

  26. De Ridder D, Plazier M, Kamerling N, Menovsky T, Vanneste S. Burst spinal cord stimulation for limb and back pain. World Neurosurg. 2013;80:642–649.e1.

    Article  Google Scholar 

  27. Thomson S. Spinal cord stimulation for neuropathic pain. Int Neuromodulation Soc. 2017

  28. Weiner RL, Yeung A, Montes Garcia C, Tyler Perryman L, Speck B. Treatment of FBSS low back pain with a novel percutaneous DRG wireless stimulator: pilot and feasibility study. Pain Med. 2016;17:1911–6.

    Article  Google Scholar 

  29. Perryman LT. Wireless neuromodulation in the management of chronic refractory FBSS back pain: preliminary prospective experience with different stimulation targets and waveforms. Anesth Perioper Manag J. 2018;2:1–4.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Omar Viswanath.

Ethics declarations

Conflict of Interest

Omar Viswanath, Ivan Urits, Emily Bouley, Jacquelin M. Peck, and William Thompson declares no conflict of interest. Dr. Kaye discloses that he is on the Speakers Bureau for Depomed, Inc. and Merck.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Other Pain

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Viswanath, O., Urits, I., Bouley, E. et al. Evolving Spinal Cord Stimulation Technologies and Clinical Implications in Chronic Pain Management. Curr Pain Headache Rep 23, 39 (2019). https://doi.org/10.1007/s11916-019-0778-9

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11916-019-0778-9

Keywords

Navigation