![dorsal column spinal cord stimulator dorsal column spinal cord stimulator](https://www.disabled-world.com/pics/1/spinal-stimulator-implant-xray.jpg)
The applied fields change the electrical potential across membranes based on the properties of tissues near the electrode, such as the dura, layer of cerebrospinal fluid, and white matter.
![dorsal column spinal cord stimulator dorsal column spinal cord stimulator](https://alansiegelmd.com/wp-content/uploads/2015/05/Spinal-Chord-NeuroStimulation.jpg)
Fundamentally, SCS, regardless of type, involves the generation of electric fields between metal contacts residing in the epidural space. 14– 16 Some of the new waveforms, such has high-frequency stimulation, have challenged our ability to elucidate their mechanisms of action within the framework of the GCT. 4, 5 The growth of neurostimulation has been fueled in part by the increasing prevalence of neuropathic pain, 6 in particular the upsurge of patients with failed back surgery syndrome (FBSS), 7, 8 and the attempts to use strategies other than chronic opioid therapy to treat chronic neuropathic pain.Īlthough SCS technology has developed greatly in the past decades, 9 the last few years have witnessed the introduction of several novel devices and stimulation modalities, including high- frequency technology, 10, 11 dorsal root ganglion (DRG) stimulation, 12 burst stimulation, 13 and other paradigms. Today, an estimated 50,000 spinal cord neurostimulators are implanted annually. 1 The first reported clinical application of dorsal column stimulation came 2 years later, and the field has gradually expanded ever since.
![dorsal column spinal cord stimulator dorsal column spinal cord stimulator](https://assets.cureus.com/uploads/figure/file/3824/article_river_8cab8d908a2e11e5a3e037114f1d2ec0-Picture2.png)
The field of spinal cord stimulation (SCS) owes its inception to the concept of gate control theory (GCT), put forth by Wall and Melzack in their landmark 1965 paper, which proposed that “control of pain may be achieved by selectively activating the large, rapidly conducting fibers”.