As discussed in the last Dr. Gearhead column (ASA Monitor 2024;88:1,6), neuromodulation can be achieved through either chemical or electrical stimulation. The advancement and application of neuromodulation has transformed the landscape for chronic pain patients suffering from intractable pain conditions. The application of electrical stimulation to peripheral nerve targets is achieved through peripheral nerve stimulators (PNS), and the application of electrical stimulation at the level of the spinal cord is achieved through dorsal column or spinal cord stimulators (SCS), with an additional option for stimulation at the level of the dorsal root ganglion (DRG). For this article, we will discuss the advancements in the field of traditional spinal cord stimulation that have helped improve the efficacy of the therapy provided and pushed the scope of application for myriad pain conditions.
Traditional SCS systems, initially introduced in 1960s, involved delivery of electrical impulses to the dorsal horn of the...
