Neuromodulation for Spine Pain Care

Electricity has been used as a modality for pain relief since antiquity. Despite early recognition of this analgesic potential, almost two centuries passed before Melzack and Wall published their seminal gate control theory in 1965. The theory, which held that electrical stimulation of the dorsal column of the spinal cord could modulate the transmission of nociceptive signals from the peripheral nervous system, represented a paradigm shift for the treatment of pain. Coupled closely with the first use of an implanted lead that provided electrical stimulation adjacent to the thoracic dorsal column and relieved pain in the chest wall of a cancer patient, these two events ushered in a new era of pain relief from the targeted application of electrical devices. Incremental progress in the field has led to various improvements in hardware design and implantation techniques, which set the stage for spinal cord stimulation (SCS) to serve as an evidence-based treatment for a variety of chronic pain conditions.