Neurological applications include stimulation of the peripheral nerve, spinal cord, and deep brain for control of pain, each having a unique history and theoretical basis of action. Shealy, et al.,34 were the first investigators to apply the concept to the spinal cord, Wall and Sweet40 and Long19 to peripheral nerves, and Adams, et al.,1 to subcortical brain.
The dorsal column stimulator, the first spinal cord system,24,34,36 initially showed good results in 90% of cases; however, this fell to 35% at the 2-year follow-up evaluation due to poor patient selection, and thus the entire mode of treatment fell into disrepute.9,12,25,26,35 Long-term results have improved with the advent of epidural stimulation, improved patient selection,18,20 and the recognition of site-specific pain control with varying electrode placement.27,29,30 Further refinements have included percutaneous insertion and trial stimulation for several days before internalization of the system.
This study summarizes our experience with long-term neurostimulation of the spinal cord for relief of chronic organic pain of nonmalignant origin by means of epidural stimulating electrodes inserted either percutaneously or through a small laminotomy.
Krainick JUThoden U: Long-term results of spinal cord stimulation in amputeesCarrea RLe Vay D (eds): Sixth International Congress of Neurological Surgery. International Congress Series 433. Amsterdam: Excerpta Medica1977288–293Sixth International Congress of Neurological Surgery. International Congress Series 433
Ray CD: Electrical and chemical stimulation of the CNS by direct means for pain control: present and future. Clin Neurosurg 28:564–5881981Ray CD: Electrical and chemical stimulation of the CNS by direct means for pain control: present and future. Clin Neurosurg 28:
Electrodes manufactured by Medtronic Inc., Minneapolis, Minnesota, and by Neuromed, Fort Lauderdale, Florida.