18. Mechanism of Action and Overview of Spinal Cord Stimulation Components

  1. Sam Eljamel2 and
  2. Konstantin V. Slavin3
  1. Sam Eljamel

Published Online: 19 JUL 2013

DOI: 10.1002/9781118346396.ch18

Neurostimulation: Principles and Practice

Neurostimulation: Principles and Practice

How to Cite

Eljamel, S. (2013) Mechanism of Action and Overview of Spinal Cord Stimulation Components, in Neurostimulation: Principles and Practice (eds S. Eljamel and K. V. Slavin), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118346396.ch18

Editor Information

  1. 2

    Centre for Neurosciences, Ninewells Hospital & Medical School, Dundee, Scotland, UK

  2. 3

    Department of Neurosurgery, University of Illinois at Chicago. Chicago, Illinois, USA

Author Information

  1. University of Dundee, Ninewells Hospital and Medical School, Dundee, UK

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118346358

Online ISBN: 9781118346396



  • implantable pulse generators;
  • neurostimulation;
  • spinal cord stimulation (SCS);
  • vasodilatation


The exact mechanism of spinal cord stimulation (SCS) is still unclear and it is likely to be multifactorial. Research in this area highlighted several mechanisms by which SCS might work including: (i) SCS leads to release of neurotransmitters in several areas along the pain pathways in the central nervous system. (ii) SCS may also downregulate electric responses of peripheral nerves. (iii) SCS changes blood flow and metabolism in several areas of the nervous system. (iv) SCS may also influence emotional responses to pain by activating anterior cingulate and prefrontal brain areas. (v) SCS induces vasodilatation in the affected organ by reducing sympathetic activity and by antidromic vasodilatation via calcitonin generelated peptides. SCS consists of components surgically implanted and external components to communicate with the implanted device. The implantable components consist of: a pulse generator (IPG), an electrode implanted, lead extenders, and lead fixators.