[Spinal cord stimulation in chronic neuropathic pain]

Seventeen years' experience of spinal cord stimulation in the treatment of chronic pain has shown it to be effective only in the case of neuropathic pain--in particular, pain due to lesions in peripheral nerves or posterior roots. In such cases, pharmacological treatment is often unsuccessful, and transcutaneous electrical nerve stimulation is only useful in certain cases. In a retrospective study of 84 patients followed for up to 16 years, 56 patients were still using their stimulators and reported continued pain relief. The majority suffered from peripheral neuralgia due to trauma or surgery and 72 per cent in that group enjoyed satisfactory relief. Trial stimulation via a temporary extension lead for at least 4-5 days is a prerequisite of good long-term results. It is concluded that spinal cord stimulation is an indispensable tool for treating chronic neuropathic pain, and it merits to be used more frequently.