ABSTRACT
Spinal cord stimulation is used primarily for chronic pain of neuropathic origin. It is less effective for mechanical or nociceptive pain, and ineffective for acute pain. The use of electricity for medical purposes has a long and colorful history, beginning with the application of electrified fish to treat gout and headache in ancient Rome, and flourishing in various forms in 19th-century Europe and America as a treatment for neuralgia and back pain. Most patients who are being considered for spinal cord stimulation would have undergone a lengthy evaluation process, often through a multidisciplinary pain management clinic. The trial is done in a standard operating room equipped with C-arm image intensifier. The patient lies prone on a radiolucent operating room table, and the entire back from T1 to sacrum, including both flanks, is prepared and draped. The position of the electrodes and the parameters of stimulation are adjusted until the patient confirms that paresthesias cover the areas of pain.
