Spinal Cord Stimulation Modulates Visceral Nociception and Hyperalgesia via the Spinothalamic Tracts and the Postsynaptic Dorsal Column Pathways: A Literature Review and Hypothesis

Krames, Elliot S.; Foreman, Robert D.

doi:10.1111/j.1525-1403.2007.00112.x

Cited by 41 publications

(29 citation statements)

References 99 publications

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“…Krames and Foreman (20) have hypothesized that the effect is mediated via the spinothalamic tract and the visceral pain-mediating postsynaptic tract deep in the dorsal columns. Furthermore, antidromic activation of sensory nerves innervating the gut may be of importance, as shown in other SCS experiments (20). In animal studies, Qin et al (26,27) has shown SCS to influence the transmission of visceroreceptor information in the spinal cord.…”

Section: Discussionmentioning

confidence: 96%

Therapeutic value of spinal cord stimulation in irritable bowel syndrome: a randomized crossover pilot study

Lind

Winter

Linderoth

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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Irritable bowel syndrome (IBS) is characterized by abdominal pain and changed bowel habits. Spinal cord stimulation (SCS) has been used for treatment of chronic pain syndromes. Animal studies have shown SCS to reduce the reaction to colonic balloon distension, known to be increased in IBS patients. To elucidate the potential for SCS as treatment for IBS, a pilot study was performed. Ten IBS patients (age 26-56 yr) were recruited. A SCS system with a four-polar electrode was implanted at the T5-T8 level. After a 2-wk run-in, a randomized, crossover design SCS during 6 wk was compared with no stimulation, with an ensuing stimulation period for 12 wk; total study period 28 wk. Patients recorded pain level, pain attacks, diarrheas, and global quality of life in a diary. At end of the study patients could choose to retain their SCS system or have it removed. Nine patients completed the whole trial. During stimulation periods the median pain scores were significantly reduced from visual analogue scale (VAS) 7 (4-8) to 3 (2.5-7) and to 4 (2-6) during early and late stimulation periods, respectively (P < 0.03-0.04). Pain attacks were numerically reduced. A few patients reported reduced number of diarrheas. After study termination, six patients chose to retain their SCS system. To conclude, SCS is a minimally invasive treatment option for pain in IBS. With SCS the pain level was reduced though with merely a trend for number of attacks and diarrheas. The efficacy of SCS in IBS pain indicates a possible usefulness in other painful bowel disorders.

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Section: Discussionmentioning

confidence: 96%

Therapeutic value of spinal cord stimulation in irritable bowel syndrome: a randomized crossover pilot study

Lind

Winter

Linderoth

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Moreover, recent works have concluded that chronic visceral pain can be defined as a neuropathic pain process and has spinal cord and brain connections, suggesting that this kind of pain is suitable to be treated with SCS (26).…”

Section: Discussionmentioning

confidence: 99%

Abdominal Angina due to Obstruction of Mesenteric Artery Treated With Spinal Cord Stimulation: A Clinical Case

Caruso

Sapio

Ragosa

et al. 2011

Neuromodulation: Technology at the Neural Interface

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“…This gate closes when an excess of large-fiber activity. The other theoretical basis of mechanisms in SCS include neural conduction blockade, activation of putative supraspinal pain centers, supraspinal or intraspinal sympathetic blockade and release of putative neuromodulators 3,[5][6][7][8]15) . DC lesion leads to decrease activation of thalamic and gracile neurons by visceral stimuli and to prevent potentiation of visceromotor reflex evoked by colorectal distention under inflammatory conditions in animal model experiments 3,12,13) .…”

Section: Discussionmentioning

confidence: 99%

“…Krames et al 6) suggested that chronic pain of visceral origin travels within the spinothalamic tracts and may be amplified by the postsynaptic dorsal column pathways. Thus, both procedures could be controlled at the spinal cord level by SCS and explain the efficacy of SCS for visceral painful disorder.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

Kim

Hong

Kim

et al. 2009

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 46 : [165][166][167] 2009 Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

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Spinal Cord Stimulation Modulates Visceral Nociception and Hyperalgesia via the Spinothalamic Tracts and the Postsynaptic Dorsal Column Pathways: A Literature Review and Hypothesis

Cited by 41 publications

References 99 publications

Therapeutic value of spinal cord stimulation in irritable bowel syndrome: a randomized crossover pilot study

Therapeutic value of spinal cord stimulation in irritable bowel syndrome: a randomized crossover pilot study

Abdominal Angina due to Obstruction of Mesenteric Artery Treated With Spinal Cord Stimulation: A Clinical Case

Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

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