Neurostimulation is a known effective treatment for neuropathic pain. Spinal cord stimulation activates the dorsal column and inhibitory interneurons that attenuate pain. Spinal cord stimulation-induced analgesia involves neurophysiological and neurochemical mechanisms. 3 Although nociceptive information is transmitted to higher centres for processing, it can be modified at primary afferent nerve terminals and at the presynaptic junction of projection neurones in the dorsal horn of the spinal cord. Spinal cord laminae I, II and V receive information from nociceptive afferent fibres of the dorsal root ganglia. However, it is estimated that approximately 1-1.5% of the population is affected by it. Due to insufficient epidemiological research and follow-up, the exact prevalence of neuropathic pain remains unknown. Depending on the location of the lesion in the nervous system, it is classified as either central or peripheral neuropathic pain. Neuropathic pain may develop secondary to a primary lesion in the nervous system or due to nervous system dysfunction. It is often characterised by disabled back or radicular limb pain following spinal surgery, with neuropathic and nociceptive components that are often insufficiently responsive to conventional therapies such as reoperation or medical treatment. 1įailed back surgery syndrome is the most common indication for spinal cord stimulation (SCS). However, medical treatment is generally unresponsive or inadequate for the management of this pain. 1 The associated neuropathic pain accounts for 30% of all MS symptomatic medication. Multiple Sclerosis may show various neurological manifestations, including neuropathic pain, dysesthesia and paraesthesia in approximately 75% of the patients, based on the severity of nerve damage.
![dorsal column stimulator surgery dorsal column stimulator surgery](https://d3i71xaburhd42.cloudfront.net/68bfa4c3e6d1dc3490568c33c8410c79a994061d/2-Figure1-1.png)
Multiple Sclerosis (MS) is a chronic demyelinating autoimmune disease and the most frequently occurring type of neuronal demyelination.