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The most common use of SCS is failed back surgery syndrome (FBSS) in the United States and peripheral ischemic pain in Europe. [4] [5]As of 2014 the FDA had approved SCS as a treatment for FBSS, chronic pain, complex regional pain syndrome, intractable angina, as well as visceral abdominal and perineal pain [1] and pain in the extremities from nerve damage.
Peripheral nerve interfaces are used for pain modulation, [7] restoration of motor function following spinal cord injury or stroke, [8] treatment of epilepsy by electrical stimulation of the vagus nerve, [9] nerve stimulation to control micturition, occipital nerve stimulation for chronic migraines and to interface with neuroprosthetics.
The use of peripheral nerve stimulation, or PNS, for the relief of chronic pain states was first reported over 30 years ago. [6] Recent studies have demonstrated that electrical stimulation of nerves leads to inhibitory input to the pain pathways at the spinal cord level. [ 7 ]
Spinal cord stimulation (SCS) is an effective therapy for the treatment of chronic and intractable pain including diabetic neuropathy, failed back surgery syndrome, complex regional pain syndrome, phantom limb pain, ischemic limb pain, refractory unilateral limb pain syndrome, postherpetic neuralgia and acute herpes zoster pain.
All forms of spinal cord stimulation have been shown to have varying degrees of efficacy to address a variety of pharmacoresistant neuropathic or mixed (neuropathic and noiciceptive) pain syndromes such as post-laminectomy syndrome, low back pain, complex regional pain syndrome, peripheral neuropathy, peripheral vascular disease and angina.
The nerve is not intended to grow back. For chronic pain it may be an alternative to a failed nerve decompression when the target nerve has no motor function and numbness is acceptable. [1] Neurectomies have also been used to permanently block autonomic function (e.g. excessive sweating in hands [2] or involuntary muscle movement causing cramps ...