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Selecting Neuromodulation Devices For Chronic Pain Conditions: A Narrative Review.

Sayed Wahezi1, Alan D Kaye2, Ugur Yener1

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Summary
This summary is machine-generated.

Neuromodulation offers advanced, personalized pain management through innovations like spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS). Standardizing training and terminology is crucial for safe and effective chronic pain care.

Keywords:
closed-loop stimulationintrathecal drug deliverylumbar radiculopathymotor cortex stimulationmultiphase stimulationneurostimulationpaintonic stimulationNeuromodulation

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Area of Science:

  • Pain Medicine
  • Neuroscience
  • Bioengineering

Background:

  • Neuromodulation is a rapidly advancing field in pain medicine, offering targeted interventions for chronic pain.
  • Technological advancements have made neuromodulation a core component of multidisciplinary pain management.
  • Variability in practice necessitates consensus frameworks for safety and efficacy.

Purpose of the Study:

  • Define current and emerging neuromodulation concepts.
  • Summarize evidence supporting neuromodulation techniques.
  • Provide a framework for individualized chronic pain management.

Main Methods:

  • Comprehensive narrative review of neuromodulation strategies.
  • Synthesis of data on spinal cord stimulation (SCS), dorsal root ganglion stimulation (DRGS), peripheral nerve stimulation (PNS), motor cortex stimulation (MCS), deep brain stimulation (DBS), and targeted drug delivery (TDD).
  • Integration of emerging concepts, classifications, indications, and technological advancements.

Main Results:

  • Neuromodulation use has expanded significantly due to technological innovations.
  • PNS shows efficacy for focal neuropathic pain; SCS is a mainstay for widespread neuropathic pain.
  • Innovations like 10-kHz high-frequency SCS, DRGS, and closed-loop systems enhance precision and patient outcomes.
  • Targeted drug delivery (TDD) offers precise, individualized adjunctive therapy.

Conclusions:

  • Neuromodulation advances at the intersection of neuroscience, bioengineering, and clinical practice.
  • Harmonizing definitions, classifications, and education is vital for future innovation.
  • Standardization will ensure safe, effective, and equitable neuromodulation patient care.