Wong S Sc, Chan C W, Cheung C W
Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Pokfulam, Hong Kong.
Department of Anaesthesiology, Queen Mary Hospital, Pokfulam, Hong Kong.
Hong Kong Med J. 2017 Oct;23(5):517-23. doi: 10.12809/hkmj176288.
Spinal cord stimulation provides analgesia through electrical stimulation of the dorsal column of the spinal cord via electrode leads placed into the epidural space. In traditional tonic stimulation, a painful sensation is replaced with paraesthesia. Spinal cord stimulation is effective in reducing neuropathic pain, enhancing function, and improving quality of life in different chronic pain conditions. Currently, there is most evidence to support its use for failed back surgery syndrome when multidisciplinary conventional management is unsuccessful. Temporary trial leads are inserted in carefully selected patients to test their responsiveness prior to permanent implantation. Newer neuromodulation modalities are now available. These include burst stimulation, high-frequency stimulation, and dorsal root ganglion stimulation. Results are encouraging to date, and they may provide superior analgesia and cover for deficiencies of traditional tonic stimulation. Although complications are not uncommon, they are rarely life threatening or permanently disabling. Nonetheless, device removal is occasionally needed.
脊髓刺激通过置于硬膜外间隙的电极导线对脊髓背柱进行电刺激来提供镇痛效果。在传统的持续性刺激中，疼痛感觉会被异常感觉所取代。脊髓刺激在减轻神经性疼痛、增强功能以及改善不同慢性疼痛状况下的生活质量方面是有效的。目前，有最多的证据支持在多学科传统管理不成功时将其用于腰椎手术失败综合征。在永久植入之前，会为精心挑选的患者插入临时试验导线以测试其反应性。现在有了更新的神经调节方式。这些包括爆发性刺激、高频刺激和背根神经节刺激。迄今为止结果令人鼓舞，它们可能提供更好的镇痛效果并弥补传统持续性刺激的不足。虽然并发症并不罕见，但很少危及生命或导致永久性残疾。尽管如此，偶尔还是需要移除装置。
