Journal article
Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions
Neuromodulation (Malden, Mass.), Vol.20(4), pp.307-321
06/2017
DOI: 10.1111/ner.12591
PMID: 28370802
Abstract
Introduction
Millions of people worldwide suffer with spasticity related to irreversible damage to the brain or spinal cord. Typical antecedent events include stroke, traumatic brain injury, and spinal cord injury, although insidious onset is also common. Regardless of the cause, the resulting spasticity leads to years of disability and reduced quality of life. Many treatments are available to manage spasticity; yet each is fraught with drawbacks including incomplete response, high cost, limited duration, dose‐limiting side effects, and periodic maintenance. Spinal cord stimulation (SCS), a once promising therapy for spasticity, has largely been relegated to permanent experimental status.
Methods
In this review, our goal is to document and critique the history and assess the development of SCS as a treatment of lower limb spasticity. By incorporating recent discoveries with the insights gained from the early pioneers in this field, we intend to lay the groundwork needed to propose testable hypotheses for future studies.
Results
SCS has been tested in over 25 different conditions since a potentially beneficial effect was first reported in 1973. However, the lack of a fully formed understanding of the pathophysiology of spasticity, archaic study methodology, and the early technological limitations of implantable hardware limit the validity of many studies. SCS offers a measure of control for spasticity that cannot be duplicated with other interventions.
Conclusions
With improved energy‐source miniaturization, tailored control algorithms, novel implant design, and a clearer picture of the pathophysiology of spasticity, we are poised to reintroduce and test SCS in this population.
Details
- Title: Subtitle
- Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions
- Creators
- Sean J Nagel - Center for Neurological Restoration, Cleveland ClinicSaul Wilson - University of Iowa Hospitals and ClinicsMichael D Johnson - Northwestern University Feinberg School of MedicineAndre Machado - Center for Neurological Restoration, Cleveland ClinicLeonardo Frizon - Center for Neurological Restoration, Cleveland ClinicMatthieu K Chardon - Northwestern University Feinberg School of MedicineChandan G Reddy - University of Iowa Hospitals and ClinicsGeorge T Gillies - University of VirginiaMatthew A Howard - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Neuromodulation (Malden, Mass.), Vol.20(4), pp.307-321
- DOI
- 10.1111/ner.12591
- PMID
- 28370802
- ISSN
- 1094-7159
- eISSN
- 1525-1403
- Number of pages
- 14
- Language
- English
- Date published
- 06/2017
- Academic Unit
- Neurology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984020791702771
Metrics
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