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Neuromodulation and Spinal Cord Stimulators: A Long Overdue Paradigm Disruption with the Interventional Pain Management Ladder 

Neuromodulation and Spinal Cord Stimulators: A Long Overdue Paradigm Disruption with the Interventional Pain Management Ladder
Chapter:
Neuromodulation and Spinal Cord Stimulators: A Long Overdue Paradigm Disruption with the Interventional Pain Management Ladder
Author(s):

Anh L. Ngo

, Bruce A. Piszel

, Mark R. Jones

, Hector J. Cases

, Alan D. Kaye

, and Mark V. Boswell

DOI:
10.1093/med/9780190626761.003.0019
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date: 17 June 2021

The Interventional Pain Management Ladder reflects a possible paradigm disruption in chronic pain management. For treatment of chronic pain after failure of pharmacotherapy, the standard of care should shift to less-invasive interventional pain management as the preferred second-line treatment prior to more tissue-disruptive spine surgery. Spinal cord stimulation with neuromodulation is an effective, reversible, and minimally invasive interventional therapy for many types of chronic and difficult-to-treat pain. This chapter presents a modern approach of least invasive therapies first prior to more tissue disruptive measures and aligns chronic pain care with treatment of other serious medical conditions, such as heart attack and stroke.

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