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A spinal cord stimulator (SCS) or dorsal column stimulator (DCS) is a type of implantable neuromodulation device (sometimes called a "pain pacemaker") that is used to send electrical signals to select areas of the spinal cord (dorsal columns) for the treatment of certain pain conditions.
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.
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 first known cochlear implant was created in 1957. Other milestones include the first motor prosthesis for foot drop in hemiplegia in 1961, the first auditory brainstem implant in 1977 and a peripheral nerve bridge implanted into the spinal cord of an adult rat in 1981.
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 ]
In most cases, a trial (test) lead placement is performed in order to assess whether the stimulation will work as expected. [8] Local anesthetic is applied to the back of the neck and a Tuohy needle is advanced towards the location of the greater occipital nerve and lesser occipital nerve under fluoroscopic guidance.