Mechanisms of Spinal Cord Stimulation in Painful Syndromes: Role of Animal Models

Spinal cord stimulation (SCS) came into clinical practice as a direct spin-off from the "gate control theory." This therapy has been used to treat neuropathic pain of peripheral origin as well as ischemic pain states, vasospastic conditions, and therapy-resistant angina pectoris. The physiological mechanisms of action for SCS are slowly emerging but still are only fragmentarily understood. This chapter will describe the research methods and basic studies used to explore these mechanisms in normal healthy animals, as well as the use of animal models exhibiting different neuropathic, vasculopathic, and other pathological conditions. Brief discussions will address human experimental and clinical studies. The results show that SCS is effective in some pain syndromes otherwise resistant to treatment.