Spinal Cord Stimulation for Pain Treatment After Spinal Cord Injury

Qian Huang1 • Wanru Duan1,2 • Eellan Sivanesan1 • Shuguang Liu1,3 • Fei Yang4 • Zhiyong Chen1 • Neil C. Ford1 • Xueming Chen5 • Yun Guan1,6,*
1Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, USA
2Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
3Department of Orthopedics, Hong Hui Hospital, Affiliated Hospital of the Medical School, Xi’an Jiaotong University, Xi’an, China
4Department of Neurobiology, Capital Medical University, Beijing, China
5Department of Orthopedics, Luhe Hospital, Capital Medical University, Beijing, China
6Department of Neurological Surgery, School of Medicine, Johns Hopkins University, Baltimore, USA

Abstract

In addition to restoration of bladder, bowel, and motor functions, alleviating the accompanying debilitating pain is equally important for improving the quality of life of patients with spinal cord injury (SCI). Currently, however, the treatment of chronic pain after SCI remains a largely unmet need. Electrical spinal cord stimulation (SCS) has been used to manage a variety of chronic pain conditions that are refractory to pharmacotherapy. Yet, its efficacy, benefit profiles, and mechanisms of action in SCI pain remain elusive, due to limited research, methodological weaknesses in previous clinical studies, and a lack of mechanistic exploration of SCS for SCI pain control. We aim to review recent studies and outline the therapeutic potential of different SCS paradigms for traumatic SCI pain. We begin with an overview of its manifestations, classification, potential underlying etiology, and current challenges for its treatment. The clinical evidence for using SCS in SCI pain is then reviewed. Finally, future perspectives of pre-clinical research and clinical study of SCS for SCI pain treatment are discussed.

Keywords

Pain; Trauma; Spinal cord injury; Spinal cord stimulation; Neuromodulation; Analgesia

[SpringerLink]

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