Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Neurosci Bull. 2019 Jun;35(3):527-539. doi: 10.1007/s12264-018-0320-9. Epub 2018 Dec 17.
In addition to restoration of bladder, bowel, and motor functions, alleviating the accompanying debilitating pain is equally important for improving the quality of life of patients with spinal cord injury (SCI). Currently, however, the treatment of chronic pain after SCI remains a largely unmet need. Electrical spinal cord stimulation (SCS) has been used to manage a variety of chronic pain conditions that are refractory to pharmacotherapy. Yet, its efficacy, benefit profiles, and mechanisms of action in SCI pain remain elusive, due to limited research, methodological weaknesses in previous clinical studies, and a lack of mechanistic exploration of SCS for SCI pain control. We aim to review recent studies and outline the therapeutic potential of different SCS paradigms for traumatic SCI pain. We begin with an overview of its manifestations, classification, potential underlying etiology, and current challenges for its treatment. The clinical evidence for using SCS in SCI pain is then reviewed. Finally, future perspectives of pre-clinical research and clinical study of SCS for SCI pain treatment are discussed.
除了恢复膀胱、肠道和运动功能外，缓解伴随的致残性疼痛对于提高脊髓损伤（SCI）患者的生活质量同样重要。然而，目前 SCI 后慢性疼痛的治疗仍然是一个未得到满足的需求。脊髓电刺激（SCS）已被用于治疗多种对药物治疗有抗性的慢性疼痛疾病。然而，由于研究有限、先前临床研究中的方法学缺陷以及对 SCS 控制 SCI 疼痛的机制探索不足，其在 SCI 疼痛中的疗效、获益情况和作用机制仍不明确。我们旨在综述最近的研究，并概述不同 SCS 模式治疗创伤性 SCI 疼痛的治疗潜力。我们首先概述其表现、分类、潜在的潜在病因以及目前治疗面临的挑战。然后回顾 SCS 在 SCI 疼痛中的临床证据。最后，讨论了 SCS 治疗 SCI 疼痛的临床前研究和临床研究的未来展望。
