• Katherine N Gibson-Corley, Oliver Flouty, Hiroyuki Oya, George T Gillies, and Matthew A Howard.
• Division of Comparative Pathology, Department of Pathology, Carver College of Medicine, University of Iowa, 500 Newton Road, 1167 ML, Iowa City, IA 52242, USA.
• Biomed Res Int. 2014 Jan 1;2014:989175.

AbstractSpinal cord stimulation has been utilized for decades in the treatment of numerous conditions such as failed back surgery and phantom limb syndromes, arachnoiditis, cancer pain, and others. The placement of the stimulating electrode array was originally subdural but, to minimize surgical complexity and reduce the risk of certain postsurgical complications, it became exclusively epidural eventually. Here we review the relevant clinical and experimental pathologic findings, including spinal cord compression, infection, hematoma formation, cerebrospinal fluid leakage, chronic fibrosis, and stimulation-induced neurotoxicity, associated with the early approaches to subdural electrical stimulation of the central nervous system, and the spinal cord in particular. These findings may help optimize the safety and efficacy of a new approach to subdural spinal cord stimulation now under development.

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