Dorsal Column Stimulator vs Spinal Cord Stimulator: What's the Difference?

The history of neuromodulation therapy dates back to the early days of electrotherapy when the first electrodes were developed. Initially, these unipolar electrodes had limitations, including a narrow field of paresthesia and restricted application. The technology has since evolved significantly, leading to the development of spinal cord stimulation (SCS) hardware, which consists of an electrode lead, extension cable, pulse generator, and programmer.

Today, SCS is widely accepted as a form of therapy for chronic intractable neuropathic pain. It works by strategically replacing unpleasant sensory experiences with a more pleasing tingling sensation referred to as parasthesia. This process is achieved through the application of low-level electrical impulses directly into the spinal cord via an SCS device inserted in the epidural space.

These electrical impulses interfere with the direct transmission of pain signals traveling along the spinal cord to the brain, effectively inhibiting chronic pain. The technique is based on the gate control theory of pain proposed by Melzack and Wall, which suggests that stimulating large diameter afferent nerve fibers in the spinal cord can help alleviate chronic pain.

In 1967, Dr. Shealy first inserted dorsal column stimulators into patients suffering from cancer pain, marking the beginning of this therapy's four-decade-long history as a treatment for refractory chronic neuropathic pain. The use of SCS has been shown to be effective in managing chronic pain, which is a leading cause of physical and emotional suffering, familial and social disruptions, disability, and work absenteeism.

It's worth noting that recent studies have found that applying an electrical field to the dorsal epidural space may activate a larger number of neural structures. While both dorsal column stimulators and SCS devices aim to alleviate chronic pain, it is essential for patients to consult with their healthcare provider to determine which treatment option best suits their individual needs.

In conclusion, while dorsal column stimulation was once the primary form of therapy for chronic intractable neuropathic pain, spinal cord stimulation has become a widely accepted alternative. Both techniques have proven effective in managing chronic pain, but SCS offers more precise control over electrical impulses and a wider range of applications. As research continues to advance our understanding of neuromodulation therapy, it is likely that we will see even more innovative approaches emerge in the future.

Dorsal column stimulator vs spinal cord stimulator