✓ Thirty patients with chronic intractable pain have had dorsal column implants and a trial of subsequent electrical self-stimulation to relieve the pain. Burning pain originating from damage to the CNS was most often relieved, while chronic bone, joint, and disc pain responded less well. Patients with severe psychiatric factors should be excluded, but preoperative selection is still difficult because of the lack of objective clinical tests. The long-term effect of the implant on the tissues of the dorsal column is still unknown and requires further evaluation. Although relief of pain has been reported for as long as 3 years, much longer follow-ups are necessary to evaluate the efficiency of this system in patients with chronic pain. Direct stimulation of the spinal cord raises a number of interesting questions in regard to perception and sensory phenomena in man but, as yet, there are no answers as to how dorsal column stimulation effects its relief of pain.
AdamsJ. Unpublished data.Adams J. Unpublished data.
HillmanPWallPD: Inhibitory and excitory factors influencing the receptive fields of lamina 5 spinal cord cells.Exp Brain Res9:284–3061969Hillman P Wall PD: Inhibitory and excitory factors influencing the receptive fields of lamina 5 spinal cord cells. Exp Brain Res 9:284–306 1969
NathanPWSmithMC: The centripetal pathway from the bladder and urethra within the spinal cord.J Neurol Neurosurg Psychiat14:262–2801951Nathan PW Smith MC: The centripetal pathway from the bladder and urethra within the spinal cord. J Neurol Neurosurg Psychiat 14:262–280 1951
NortonAC: The dorsal column system of the spinal cord.UCLA Brain Information Network.U S Dept of Health Education1969Norton AC: The dorsal column system of the spinal cord. UCLA Brain Information Network. U S Dept of Health Education 1969
SweetWHWepsicJG: Treatment of chronic pain by stimulation of fibers of primary afferent neurone.Trans Amer Neurol Ass93:103–1071968Sweet WH Wepsic JG: Treatment of chronic pain by stimulation of fibers of primary afferent neurone. Trans Amer Neurol Ass 93:103–107 1968