Surg Neurol
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Twenty-three patients underwent implantation of a stimulator system and were followed for 6-20 months. Twenty patients estimated between 50% and 100% pain relief. ⋯ Reduced drug intake and improved social performance were associated with subjective improvement. The surgical technique is given, complications are analyzed and parameters are discussed.
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Electrical stimulation of the nervous system has been advocated as a means of alleviating pain in situations in which more conventional methods have been ineffective. A chronically implanted electrode on the dorsal surface of the spinal cord may prove to be a valuable adjunct to the neurosurgeon's armamentarium for pain control in selected individuals. The physiologic basis for this action is unclear but has been related to Melzack and Wall's gate control theory. This preliminary report deals with a series of patients treated with implanted dorsal cord stimulators.
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The long-term (three-year) effect of dorsal column electrical stimulation for chronic pain in a group of 30 patients was generally decreased effectiveness with time, and increased stimulation thresholds. Further animal and human studies of this technique are recommended.
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Sixty-nine patients with chronically incapacitating pain were treated with an implantable stimulator over the posterior columns of the spinal cord. Evaluations at 24, 30 and 34 months showed a progressive decrease in the number of patients considered to have an excellent result. Evaluation of 60 patients with pain of benign origin after implantation of the stimulating device showed only ten patients who could be considered to have an excellent result on the basis of their own report of pain relief. The most common failure of the stimulating devices was failure of stimulation into a painful part.