Provenzano David A, Heller Jared A, Hanes Michael C
Pain Diagnostics and Interventional Care, Sewickley, PA, USA.
Western PA Surgery Center, Wexford, PA, USA.
J Pain Res. 2021 Feb 17;14:463-479. doi: 10.2147/JPR.S249580. eCollection 2021.
Neurostimulation techniques for the treatment of chronic low back pain (LBP) have been rapidly evolving; however, questions remain as to which modalities provide the most efficacious and durable treatment for intractable axial symptoms. Modalities of spinal cord stimulation, such as traditional low-frequency paresthesia based, high-density or high dose (HD), burst, 10-kHz high-frequency therapy, closed-loop, and differential target multiplexed, have been limitedly studied to determine their efficacy for the treatment of axial LBP. In addition, stimulation methods that target regions other than the spinal cord, such as medial branch nerve stimulation of the multifidus muscles and the dorsal root ganglion may also be viable treatment options. Here, current scientific evidence behind neurostimulation techniques have been reviewed with a focus on the management of chronic axial LBP.
用于治疗慢性腰痛(LBP)的神经刺激技术一直在迅速发展;然而,对于哪种方式能为顽固性轴向症状提供最有效和持久的治疗仍存在疑问。脊髓刺激的方式,如传统的基于低频感觉异常、高密度或高剂量(HD)、爆发式、10千赫高频治疗、闭环和差异靶点多路复用,在确定其治疗轴向LBP的疗效方面研究有限。此外,针对脊髓以外区域的刺激方法,如多裂肌内侧支神经刺激和背根神经节,也可能是可行的治疗选择。在此,我们回顾了神经刺激技术背后的当前科学证据,重点是慢性轴向LBP的管理。