Campbell J N
Appl Neurophysiol. 1981;44(4):181-6. doi: 10.1159/000102200.
Stimulation of the spinal cord may be very helpful in controlling chronic pain. Traditionally it has been thought that pain control derives from antidromic activation of large-diameter primary afferents in the posterior columns, which inhibits activation of second-order neurons. Evidence against this hypothesis is presented. In addition, it is pointed out that stimulation of the anterolateral quadrant contralateral to the side of pain may require less current for pain control than stimulation with electrodes over the posterior cord. It is suggested that 'frequency-related conduction block' in the spinothalamic tract or in Lissauer's tract may play a role in pain relief. Because of uncertainty about the mechanism it is suggested that the term 'dorsal column stimulation' be replaced by 'spinal axis stimulation'.
脊髓刺激在控制慢性疼痛方面可能非常有帮助。传统上认为，疼痛控制源于后柱中大直径初级传入纤维的逆向激活，这会抑制二级神经元的激活。本文提出了反对这一假说的证据。此外，还指出，与在后脊髓上方使用电极进行刺激相比，在疼痛对侧的前外侧象限进行刺激可能需要较少的电流来控制疼痛。有人认为，脊髓丘脑束或 Lissauer 束中的“频率相关传导阻滞”可能在疼痛缓解中起作用。由于机制尚不确定，建议将“背柱刺激”一词替换为“脊髓轴刺激”。
