Spinal Cord Stimulation

Over 25 years ago, electrical stimulation of the spinal cord using implanted electrodes was introduced as a reversible technique for the management of chronic, intractable pain.1 As a reversible alternative to ablative procedures, this prototypical “neuroaugmentative” procedure was appealing; but the indications for neurosurgical intervention for chronic, benign pain were not widely understood at that time. As the behavioral and psychological issues in pain management have become more widely appreciated, and as programs specializing in chronic pain have proliferated, the process of patient selection has been refined considerably. At the same time, there have been major improvements in implantable spinal cord stimulation devices, which have significantly enhanced clinical results.2,3