Chakravarthy Krishnan, Reddy Rajiv, Al-Kaisy Adnan, Yearwood Thomas, Grider Jay
Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, San Diego, CA, USA.
VA San Diego Healthcare System, San Diego, Ca, USA.
J Pain Res. 2021 Sep 7;14:2767-2776. doi: 10.2147/JPR.S323372. eCollection 2021.
Spinal cord stimulation has seen unprecedented growth in new technology in the 50 years since the first subdural implant. As we continue to grow our understanding of spinal cord stimulation and relevant mechanisms of action, novel questions arise as to electrical dosing optimization. Programming adjustment - dose titration - is often a process of trial and error that can be time-consuming and frustrating for both patient and clinician. In this report, we review the current preclinical and clinical knowledge base in order to provide insights that may be helpful in developing more rational approaches to spinal cord stimulation dosing. We also provide key conclusions that may help in directing future research into electrical dosing, given the advent of newer waveforms outside traditional programming parameters.
自首次进行硬膜下植入以来的50年里，脊髓刺激技术在新技术方面取得了前所未有的发展。随着我们对脊髓刺激及其相关作用机制的理解不断深入，关于电剂量优化出现了新的问题。编程调整——剂量滴定——通常是一个反复试验的过程，这对患者和临床医生来说都可能既耗时又令人沮丧。在本报告中，我们回顾了当前的临床前和临床知识库，以便提供一些见解，这些见解可能有助于开发更合理的脊髓刺激剂量方法。鉴于传统编程参数之外出现了更新的波形，我们还提供了一些关键结论，可能有助于指导未来关于电剂量的研究。
