Spinal Cord Stimulation for Managing Angina from Coronary Artery Disease

The analgesic effect of SCS has been known since 1967 when Norman Shealy was able to show electrical stimulation of the dorsal column of spinal cord suppressed the response to noxious stimulation in animal study and abolished pain in a patient with terminal cancer (Shealy et.al. 1967). The rationale for this technique was based on the "gate theory" of pain proposed by Melzack and Wall (Melzack &Wall 1965). The SCS has been used mostly in patients suffering chronic low back pain but has also been used successfully in a variety of other conditions including radiculopathy, complex regional pain syndrome, post-herpetic neuralgia, multiple sclerosis, and other types of neuropathic pain. Moreover, several studies were able to demonstrate the pain relieving effect of SCS in peripheral vascular disease, associated with an increase in local blood flow as well as angina pectoris (Augustinsson et.al., 1985; Cook et.al., 1976; Jacobs et.al., 1990; Murphy et.al., 1987).