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/ Epub 2023 Dec 21.


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