Spinal Cord Stimulation: Clinical Efficacy and Potential Mechanisms.
Spinal Cord Stimulation: Clinical Efficacy and Potential Mechanisms.
复制标题
脊髓刺激：临床功效和潜在机制。
DOI：
10.1111/papr.12692
复制
发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Raja SN
中科院分区：
文献类型：
--
作者：
Sdrulla AD;Guan Y;Raja SN
脊髓电刺激（SCS）是一种用于治疗慢性神经性疼痛的微创疗法。SCS是阿片类药物的安全有效的替代药物，多项随机对照研究已证明其对难以治疗的神经性疾病（如腰椎手术失败综合征）的疗效。传统SCS被认为通过激活背柱Aβ纤维介导疼痛缓解，导致对感觉和疼痛阈值的可变影响，以及高阶皮质处理的可测量改变。尽管沃尔和梅尔扎克的门控理论所提出的抑制增强仍然是主要的解释模型，但其他节段性和脊髓上机制也被描述。在一些研究中，新型非标准刺激波形（如高频和脉冲群）在临床上上级传统SCS，但其作用机制仍有待确定。需要进行更多的机制和临床研究，以更好地了解不同神经病变的最佳刺激策略，改善患者选择并优化疗效。
Spinal cord stimulation (SCS) is a minimally invasive therapy used for the treatment of chronic neuropathic pain. SCS is a safe and effective alternative to medications such as opioids, and multiple randomized controlled studies have demonstrated efficacy for difficult‐to‐treat neuropathic conditions such as failed back surgery syndrome. Conventional SCS is believed mediate pain relief via activation of dorsal column Aβ fibers, resulting in variable effects on sensory and pain thresholds, and measurable alterations in higher order cortical processing. Although potentiation of inhibition, as suggested by Wall and Melzack's gate control theory, continues to be the leading explanatory model, other segmental and supraspinal mechanisms have been described. Novel, non‐standard, stimulation waveforms such as high‐frequency and burst have been shown in some studies to be clinically superior to conventional SCS, however their mechanisms of action remain to be determined. Additional studies are needed, both mechanistic and clinical, to better understand optimal stimulation strategies for different neuropathic conditions, improve patient selection and optimize efficacy.
登录
查看更多内容
影响因子：
3
作者：
Buonocore, Michelangelo;Bonezzi, Cesare;Barolat, Giancarlo
通讯作者：
Barolat, Giancarlo
影响因子：
2.5
作者：
Crosby, Nathan D.;Janik, John J.;Grill, Warren M.
通讯作者：
Grill, Warren M.
影响因子：
2.8
作者：
Arle, Jeffrey E.;Mei, Longzhi;Shils, Jay L.
通讯作者：
Shils, Jay L.
DOI：
10.1111/pme.12294
发表时间：
2014-03
期刊：
Pain medicine (Malden, Mass.)
影响因子：
--
作者：
Al-Kaisy A;Van Buyten JP;Smet I;Palmisani S;Pang D;Smith T
通讯作者：
Smith T
影响因子：
2.7
作者：
Baber Z;Erdek MA
通讯作者：
Erdek MA