Spinal cord anatomy, pain, and spinal cord stimulation mechanisms

The effectiveness and mechanisms of spinal cord stimulation described in literature rely on a proper understanding of spinal cord anatomy and pain theory. In this article we provide an overview of relevant spinal cord anatomy, pain mechanisms, and theories of pain perception. This includes the gate control theory that is the foundation for spinal cord stimulation as a treatment for chronic pain. Thereafter, we describe the different mechanisms of spinal cord stimulation. Specifically, there are considerations in anatomy, electrophysiology, neurochemistry, and neurophysiology of the central nervous system that play a role in how spinal cord stimulation modulates the pain “gate” system.