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Minimally Invasive Wireless Spinal Cord Stimulation: A Novel Approach for Refractory Angina in Women

Refractory angina (RA) persists even after thorough treatment for coronary artery disease. In such difficult situations, neuromodulation offers effective alternative management. One such minimally invasive procedure is spinal cord stimulation (SCS), a rapidly evolving therapy in the treatment of pain management. SCS has been in use to control RA and in some reports exhibited beneficiary results. However, several equipment-related complications have been reported, mainly attributed to the bulky implant material and the implantable pulse generator.Recent advancements in minimally invasive surgical methods and electronics resulted in implantable electrode coupled with nanotechnology-operated antenna. This is the smallest pulse generator in the field of neuromodulation at present.The equipment in this minimalistic approach involved percutaneous implantation of a single electrode (with embedded microelectronic sensors) at the required anatomical location, operated by means of wireless antenna placed in the vicinity of the implant and moderated by both the patient as well as the clinician. The advantage with the nanoeletrode stimulation include reduced surgical trauma/health care costs/surgical duration and improved cosmetic result, especially in women.This minimalistic wireless neuromodulation (WNM) has been successful in the management of chronic pain in failed back surgery syndrome (FBSS), herpetic neuralgia, complex regional pain syndrome (CRPS), and facial pain. SCS with WNM could increase the indications in RA and possibly improves the outcome of these patients.