Functional Stimulation and Imaging to Predict Neuromodulation of Chronic Low Back Pain

Timothy J Florence; Ausaf Bari; Andrew C Vivas

doi:10.1016/j.nec.2023.11.004

Functional Stimulation and Imaging to Predict Neuromodulation of Chronic Low Back Pain

Neurosurg Clin N Am. 2024 Apr;35(2):191-197. doi: 10.1016/j.nec.2023.11.004. Epub 2023 Dec 21.

Authors

Timothy J Florence¹, Ausaf Bari¹, Andrew C Vivas²

Affiliations

¹ UCLA Neurosurgery, 300 Stein Plaza Driveway, Suite 562, Los Angeles, CA 90095, USA.
² UCLA Neurosurgery, 300 Stein Plaza Driveway, Suite 562, Los Angeles, CA 90095, USA. Electronic address: avivas@mednet.ucla.edu.

PMID: 38423734
DOI: 10.1016/j.nec.2023.11.004

Abstract

Back pain is one of the most common aversive sensations in human experience. Pain is not limited to the sensory transduction of tissue damage; rather, it encompasses a range of nervous system activities including lateral modulation, long-distance transmission, encoding, and decoding. Although spine surgery may address peripheral pain generators directly, aberrant signals along canonical aversive pathways and maladaptive influence of affective and cognitive states can result in persistent subjective pain refractory to classical surgical intervention. The clinical identification of who will benefit from surgery-and who will not-is increasingly grounded in neurophysiology.

Keywords: Chronic low back pain; Chronic pain; Deep brain stimulation; Neuromodulation; Pain centralization.

Publication types

Review

MeSH terms

Chronic Pain* / therapy
Humans
Low Back Pain* / therapy