| Peripheral Nerve Stimulation and Spinal Cord Stimulation for Intractable Neuropathic Pain |
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Sang Woo Kim, Seong Ho Kim |
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Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea |
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| Abstract |
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Neuropathic pain unresponsive to medical or general surgical treatment can be controlled effectively by neurostimulation. Peripheral nerve stimulation has been used for the treatment for intractable chronic pain arising from peripheral nerve trauma and entrapment with or without a sympathetic component with electrodes implanted proximal to the injury site. Therapeutic electrostimulation of the gasserian ganglion or the trigeminal nerve roots could be effectively used to treat the patients who suffer from atypical trigeminal neuralgia. Medically intractable occipital neuralgia can be relieved by subcutaneous electrostimulation of a percutaneously placed multipolar lead in the region of affected occipital nerve at the level of approximately C1. Sacral nerve stimulation is an effective and durable approach to chronic pelvic pain and perineal pain associated with voiding symptoms. Spinal cord stimulation (SCS) is the most common of the implanted stimulator procedure for intractable pains. Certain specific diagnoses have been established as indications for SCS. They are failed back surgery syndrome, pain of peripheral nerve injury including reflex sympathetic dystrophy, ischemic pain due to occlusive or vasoactive arterial diseases, stump pain, and well-circumscribed segmental pain in spinal cord lesions. |
| Key Words:
Intractable neuropathic pain, Spinal cord stimulation, Peripheral nerve stimulation, Occipital nerve stimulation, Sacral nerve stimulation. |
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