Neurophysiology and neuroanatomy of spinal cord electrode stimulation for the treatment of chronic pain – State of art

Among the various types of pain, such as nociceptive and nociplastic, the neuropathic pain is classified as a condition associated with damage to the somatosensory system, and is responsible for chronic painful experiences in affected patients. About 7–10% of the general population suffers from neuropathic pain, a condition that significantly reduces quality of life. There are various forms of intervention, being pharmacological approach a option that involves the use of antidepressants and anticonvulsivants. On the other hand, the use of neuroestimulation, a kind of surgical intervention also can be considered as an alternative. The use of medullary stimulation with electrodes has been applied to conditions refractory to medication, based on the neuroanatomical and neurophysiological principles of pain conduction in the dorsal horn of the spinal cord. This article aims to detail the mechanisms of pain generation and transmission, the participation of the endogenous descending pathway and, the functioning and application of the medullary electrode in chronic pain conditions.