Neuromodulation therapierefraktärer Schmerzen – ein Update

Die Neuromodulation zur Behandlung chronischer Schmerzen hat in den letzten Jahren an Bedeutung gewonnen. Dies hängt nicht nur mit verbesserter Hardware, sondern auch mit der Entwicklung neuer Implantationstechniken sowie neuer Stimulationsprogramme zusammen. Durch den Einsatz bei axialen Rückenschmerzen, aber auch bei neuen Indikationen wie der diabetischen Polyneuropathie und peripheren Schmerzsyndromen konnte das Indikationsspektrum deutlich erweitert werden. Dieser Artikel hat neben der klassischen epiduralen Rückenmarkstimulation die neuen Indikationen und neuen Techniken zum Thema.

Abstract

Neuromodulation therapies using implants that apply electric currents to modulate the nervous system – such as spinal cord stimulation, dorsal root ganglion stimulation, and peripheral nerve stimulation – are well-established treatment modalities for patients suffering from chronic pain syndromes. The appropriate choice of stimulation site, indications, and neuromodulation system can significantly improve outcomes in patients with a high disease burden, leading to a dramatic increase in health-related quality of life and functionality. Advances in technology and new stimulation settings have expanded clinical indications, allowing for successful treatment of various pain syndromes. Minimally invasive approaches have reduced complication rates and enabled a whole-body, on-label approach for peripheral nerve stimulation. This update aims to provide an overview of surgical approaches, technological developments, and clinical indications for the treatment of chronic pain syndromes with neurostimulation.

Schlüsselwörter

Rückenmarkstimulation (SCS) - Spinalganglienstimulation (DRGS) - Periphere Nervenstimulation (PNS) - Periphere Nervenfeldstimulation (PNfS) - Neuromodulation - chronischer Schmerz

Keywords

neuromodulation - spinal cord stimulation - dorsal root ganglion stimulation - peripheral nerve stimulation

Publication History

Article published online:
07 April 2025

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