Highest Ranking Oral Abstracts

Neuromodulation has traditionally focused on stimulation of the dorsal columns, yet chronic pain processing involves multiple spinal cord circuits. Growing interest is emerging in previously overlooked anatomical corridors, including the dorsal root entry zone (DREZ) and the lateral spinal cord "gutter," where primary afferent fibers enter the spinal cord and interact with dorsal horn networks. These regions may represent precision targets for modulating segmental nociceptive processing. Similarly, ventral and ventrolateral spinal cord regions, historically avoided due to motor activation, may provide opportunities for intentional engagement of descending modulatory and propriospinal circuits. With advances in lead design and programming, these areas can now be explored more safely and selectively.