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spinal cord stimulator
A spinal cord stimulator is a device used to exert pulsed electrical signals to the spinal cord to control chronic pain. Further applications are in motor disorders. The lumbar spinal cord is a preferred target for the control of spinal spasticity or augmentation of standing and stepping capabilities.〔(【引用サイトリンク】url=http://movementrecovery.org/drupal7/research )〕 Spinal cord stimulation (SCS), in the simplest form, consists of stimulating electrodes, implanted in the epidural space, an electrical pulse generator, implanted in the lower abdominal area or gluteal region, conducting wires connecting the electrodes to the generator, and the generator remote control. SCS has notable analgesic properties and, at the present, is used mostly in the treatment of failed back surgery syndrome, complex regional pain syndrome and refractory pain due to ischemia.
==History==
Electrotherapy of pain by neurostimulation began shortly after Melzack and Wall proposed the gate control theory in 1965.〔Melzack, R., and Wall, P.D. (1965). Pain mechanisms: a new theory" ''Science'' 150:971–979.〕 This theory proposed that nerves carrying painful peripheral stimuli and nerves carrying touch and vibratory sensation both terminate in the dorsal horn (the gate) of spinal cord. It was hypothesized that input to the latter could be manipulated to “close the gate” to the former. As an application of the gate control theory, et al. implanted the first spinal cord stimulator device directly on the dorsal column for the treatment of chronic pain〔Shealy, C.N., Mortimer, J.T., and Resnick, J. Electrical inhibition of pain by stimulation of the dorsal columns: Preliminary reports. J. Int. Anesth. Res. Soc, 46:489–491, 1967.〕 and in 1971, Shimogi and colleagues first reported the analgesic properties of epidural spinal cord stimulation.〔Shimoji K, Higashi H, Kano T, Asai S, Morioka T. Electrical management of intractable pain. (1971) Masui (The Japanese journal of anesthesiology), 20: 444–447.〕 Since then this technique has undergone numerous technical and clinical developments.〔Dilorenzo, D. J.; and Bronzino, J. D. (2008). Neuroengineering. CRC Press. Chapter 7. ISBN 978-0-8493-8174-4〕
At this time neurostimulation for the treatment of pain is used with nerve stimulation, spinal cord stimulation, deep brain stimulation, and motor cortex stimulation.
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