Electrical stimulation of the spinal cord: a critical review

Electrical stimulation of the spinal cord has been practiced as a therapy by the medical community for nearly two decades. Despite optimistic expectations, interest and participation in spinal cord stimulation have been moderate. Considering the declining number, worldwide, of papers dealing with this therapeutic method in humans, it appears that, following a surge of interest in the late 1970s, the technique is losing adherents (or, at best, progressing slowly.) Over the same period there has been rapid growth of much new clinical technology, particularly cardiac pacing. The reasons for this slow progress lie in several areas, including technology and neuroanatomy. It remains for the neurological research scientist to identify more precise and effective approaches to central neural therapy, and for the engineer to find better methods of directing stimulating energies to specific target tissues. Until such breakthroughs are realized, implanting physicians can only continue to analyze patient data in an attempt to refine the techniques that are possible today.