TY - CHAP M1 - Book, Section TI - Psychological Evaluation of Patients for Spinal Cord Stimulator Implantation A1 - Wootton, R. Joshua A2 - Bajwa, Zahid H. A2 - Wootton, R. Joshua A2 - Warfield, Carol A. PY - 2016 T2 - Principles and Practice of Pain Medicine, 3e AB - More than 45 years ago, Shealy and colleagues introduced the concept of spinal cord stimulation (SCS) as a means of electrically inhibiting pain that was consonant with Melzack and Wall's gate-control theory of pain.1-3 SCS, or neuromodulation, is now a widely used technique that delivers pulsed electrical signals, principally to the dorsal column of the spinal cord, for indications that include failed back surgery syndrome, traumatic nerve injury, postherpetic neuralgia, complex regional pain syndrome, refractory angina pectoris, peripheral vascular disease, neuropathic pain, and visceral pain.4,5 The technique is minimally invasive and reversible; electrodes can frequently be placed percutaneously under local anesthesia during outpatient surgery; and, unlike more invasive surgical approaches, it does not ablate pain pathways or alter anatomy.6,7 Although the exact mechanism of action is variously described, it is generally held that pain reduction is achieved by inhibiting the conduction of primary neural pathways through the stimulation of large nerve fibers that override the transmission of smaller nerve fibers more directly involved in pain sensation.6,8-10 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - neurology.mhmedical.com/content.aspx?aid=1131931676 ER -