Journal article
Spinal Cord Stimulation for Visceral Pain: Present Approaches and Future Strategies
Pain medicine (Malden, Mass.), Vol.21(10), pp.2298-2309
10/01/2020
DOI: 10.1093/pm/pnaa108
PMID: 32719876
Abstract
AbstractIntroductionThe introduction of successful neuromodulation strategies for managing chronic visceral pain lag behind what is now treatment of choice in refractory chronic back and extremity pain for many providers in the United States and Europe. Changes in public policy and monetary support to identify nonopioid treatments for chronic pain have sparked interest in alternative options. In this review, we discuss the scope of spinal cord stimulation (SCS) for visceral pain, its limitations, and the potential role for new intradural devices of the type that we are developing in our laboratories, which may be able to overcome existing challenges.MethodsA review of the available literature relevant to this topic was performed, with particular focus on the pertinent neuroanatomy and uses of spinal cord stimulation systems in the treatment of malignant and nonmalignant gastrointestinal, genitourinary, and chronic pelvic pain.ResultsTo date, there have been multiple off-label reports testing SCS for refractory gastrointestinal and genitourinary conditions. Though some findings have been favorable for these organs and systems, there is insufficient evidence to make this practice routine. The unique configuration and layout of the pelvic pain pathways may not be ideally treated using traditional SCS implantation techniques, and intradural stimulation may be a viable alternative.ConclusionsDespite the prevalence of visceral pain, the application of neuromodulation therapies, a standard approach for other painful conditions, has received far too little attention, despite promising outcomes from uncontrolled trials. Detailed descriptions of visceral pain pathways may offer several clues that could be used to implement devices tailored to this unique anatomy.
Details
- Title: Subtitle
- Spinal Cord Stimulation for Visceral Pain: Present Approaches and Future Strategies
- Creators
- Royce W Woodroffe - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IowaAmy C Pearson - Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, IowaAmy M Pearlman - Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IowaMatthew A Howard - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IowaHaring J W Nauta - Department of Neurosurgery, University of Louisville, Louisville, KentuckyS J Nagel - Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USAY S Hori - Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USAAndre G Machado - Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USALeonardo Almeida Frizon - Department of Neurosurgery, Hospital Marcelino Champagnat, Curitiba, PR, BrazilLogan Helland - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IowaMarshall T Holland - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IowaGeorge T Gillies - Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, Virginia, USASaul Wilson - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Pain medicine (Malden, Mass.), Vol.21(10), pp.2298-2309
- DOI
- 10.1093/pm/pnaa108
- PMID
- 32719876
- ISSN
- 1526-2375
- eISSN
- 1526-4637
- Grant note
- name: Direct Spinal Therapeutics, Inc.
- Language
- English
- Date published
- 10/01/2020
- Academic Unit
- Neurology; Iowa Neuroscience Institute; Anesthesia; Urology; Neurosurgery; Otolaryngology
- Record Identifier
- 9984070288102771
Metrics
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