The History of Spinal Cord Stimulation
Paul G. Kreis, MD, is the Medical Director, Division of Pain Medicine, Professor of Anesthesiology and Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis. Scott M. Fishman, MD, is Chief, Division of Pain Medicine, Professor of Anesthesiology, Department of Anesthesiology and Pain Medicine, University of California, Davis. Together they wrote, Spinal Cord Stimulation: Percutaneous Implantation Techniques, which looks at the basic multidisciplinary information necessary for understanding SCS and pursing safe and effective implantation. In the excerpt below we look at the origins of sensory stimulation.
Sensory stimulation has been used to treat pain since antiquity. It is believed that anciet Egyptians may have used electrogenic fish to treat ailments 4,500 years ago. One such fish, the black torpedo fish, was used for centuries by the ancient Greeks and Romans.
The live fish was placed over the painful site, and the patient endured the electrical discharge from the fish until the pain was relieved. The Roman physician Scribonius Largus recorded the medical use of the torpedo fish in 46 CE, and Claudius Galen (131-201 CE) also described shocks from the torpedo fish to treat gout and headache.
An 1871 publication by Beard and Rockwell presented a case of “Faradization” and described the application of faradic current (i.e., discontinuous, asymmetric, alternating current) to stimulate muscles and nerves in a subject using a direct current inductorium device. Units…were also used by early researchers, including Benjamin Franklin, for pain relief, as well as for treatment of other ailments.
The first modern attempt at electrical stimulation of the brain took place in a conscious patient in 1874. The patient had ostemyelitis of the scalp, and the brain was exposed during debridgement. Muscle contractions were apparent when the exposed motor cortex as subjected to electrical stimulation but not when it was mechanically stimulated. Not until 1948, however, were electrodes successfully implanted in the brain, to treat a patient with psychiatric disorder.
The Electreat, the first electrical stimulator designed specifically for therapeutic use, was patented by Charles Willie Kent in 1919. It appears to have been remarkably similar to transcutaneous electrical nerve stimulation units that wold appear later in the century.
Advertised to the public as a cure-all therapy, an estimated 250,000 Electreat stimulators were sold over the next 25 years. Eventualy, Keat would be the first individual prosecuted under the new 1938 Food, Drug, and Cosmetic Act for making unsubstantiated medical claims for the device. The Electreat Company was subsequently forced to limit its claims to pain relief alone.