Spinal Cord Stimulation

Spinal Cord Stimulation

Recently, spinal cord stimulation has become increasingly popular and sought after as a means of treatment for back-related pain and ailments. Also called neurostimulation, spinal cord stimulation is a procedure that utilizes electrical pulses to intercept and interrupt pain signals sent from the nerves in the spine to the brain. This is accomplished through a small electronic device that is implanted into the body, near the spine. This device periodically emits these electronic signals to the afflicted area and has many similarities to a modern-day cardiac pacemaker; which in turn, led to some calling the device a pacemaker for pain.

Qualified candidates for this treatment first go through a trial period with a similar but different set of equipment. This helps the doctor gain a better understanding of the patient’s pain before actually implanting the device.

What Happens During the Trial Run?

Before the actual procedure begins, successfully qualified candidates will first go through a trial period. During this process, instead of having the electronic device implanted into the patient’s body, they will have wires inserted into their bodies which are attached to an external machine. The process itself is similar to the usual therapy and lasts five to seven days while taking note of the patient’s level of pain and discomfort throughout the process. This process begins via the following steps:

  • Step 1: Anesthesia is applied to the target area. A sedative may also be applied as well.
  • Step 2: Utilizing a special needle that holds the wiring, the doctor will use x-ray guidance to insert the needle into the spaces surrounding the spine, called the epidural space.
  • Step 3: Through communication between both the doctor and patient, the doctor will ensure that the wires are placed in the correct position based on the response of pain the patient feels.

After the trial is set up, the patient will have the wiring taped to their body and attached to a small external electronic device; typically attached to a belt. This belt will then be placed onto the patient along with a controller for the patient to adjust the electronic pulses on their own (which is usually programmed based on the earlier feedback between the two). The patient will be monitored for a short while and be asked to rest before being allowed to go home. During the trial period, the patient is expected to make notes of the stimulation before returning to the doctor.

What Happens During the Procedure

Although similar to the procedure involved in the trial process, there are a few key differences between the trial run and actual neurostimulation. One of the key differences is the implanting of the actual generator. A basic idea of the steps involved during the procedure, however, are as follows:

  • Step 1: Anesthesia is applied to the target area. A sedative may also be applied as well.
  • Step 2: Utilizing a special needle that holds the wiring, the doctor will use x-ray guidance to insert this needle into the spaces surrounding the spine, called the epidural space.
  • Step 3: Permanent leads are implanted; although depending on the procedure during the trial period, this step might have already been completed. It is also possible that a part of the lamina, a small bone covering the back of the spine, may be removed to make space for the permanent leads.
  • Step 4: Through communication between both the doctor and patient, the doctor will ensure that the wires are placed in the correct position based on the response of pain the patient feels.
  • Step 5: An incision is made for the generator to be inserted in. The generator itself can vary in size with the largest ones being no bigger than a stopwatch. It can be placed either on the upper chest, upper buttocks, or the abdomen.
  • Step 6: The generator is implanted into the body. As comfort is an important detail, the patient’s preference will be prioritized as things such as sleeping habits and positions have to be taken into account.
  • Step 7: The wires are tunneled from the leads to the generator and connected, which allows the generator to be turned on.
  • Step 8: The incision is closed, and the recovery process begins.

After surgery, recovery can take about two to three weeks before patients can resume their normal daily activities. It should be noted, however, that complete recovery has been reported to sometimes take six to eight weeks and that physical activity should be limited for around three months to prevent the permanent leads from shifting.

Who Is Spinal Cord Stimulation For?

Successful candidates for spinal cord stimulation will be identified through our own evaluation at the clinic. This will include gathering a patient’s medical history and condition followed by a thorough assessment by our certified specialists.

As the treatment is used to aid those with back pain it will greatly benefit those who suffer from chronic back pain. Below is a list of some of the ailments that can see improvement from spinal cord stimulation. Any person who suffers from any of the below should contact us immediately to schedule an evaluation.

  • Failed Back Syndrome: A term used to describe chronic pain after one or more failed surgeries to alleviate back, neck, leg, buttocks, or arm pain.
  • Arachnoiditis: This is the inflammation or scarring of the protective layer found on spinal nerves; also called the meninges.
  • Chronic Neck Pain: This is pain within the cervical spine or neck area which has lasted for three or more months and can be associated with pain in the arms.
  • Chronic Back Pain: This is pain within the thoracic or lumbar (back) area which has lasted for three or more months and can be associated with pain in the buttocks or legs.

Advantages of Spinal Cord Stimulation

Getting effective treatment for chronic back and/or neck pain can be challenging because of the multitude of nerves within the spine. It is for that reason why many turn to spinal cord stimulation. Another reason is that the research conducted with the procedure supports spinal cord stimulation as a viable treatment option for chronic pain; especially for those who had no other options available. Below further reasons why spinal cord stimulation is such a great means of treatment:

  • Spinal cord stimulation is reversible; unlike most surgical operations. Should a person decide at any time to stop with the therapy, it is possible for them to have the wiring, the generator, and the electrical contacts all removed with no damage to their spine.
  • The procedure allows patients to reduce the use of opioids for managing their chronic back and/or neck pain.
  • The therapy itself targets pain at the source, unlike oral medication which does not have a focused area for concentration.
  • The pain relief is adjustable as the hand-held controller will allow patients to determine for themselves just what level of pain relief they need at any given moment.
  • In comparison to other alternatives, spinal cord stimulation is very cost-effective; even when compared to some non-surgical solutions available.

Risks, Side Effects, and Disadvantages of Spinal Cord Stimulation

While the side-effects associated with spinal cord stimulation are limited, they are not uncommon; especially as it involves a surgical procedure. After the procedure, opioids can be considered for coping with post-operation pain for two to four weeks; however, because of their addictive nature and their potential side effects, it’s best to use them for a shorter period if possible. In the case of swelling, it helps if the type of swelling can be described to the doctor via a family member or friend so that they can better assist the patient.

Other than post-surgery side-effects, there are some cases of complications occurring with regards to the device itself. These complications arise typically with the shifting, breakage, or failed connection of the leads within the body after the operation. While common in the past, the advances of the technology within recent years have seen a decline in these complications. In some rare cases, there have been reports of hemorrhaging in the epidural space, neurological damage to the nerve root or spine, and infections.

At Progressive Pain and Rehabilitation, we provide the best, and latest Regenerative Medicine services aimed to ensure you’re back to your best feeling. Contact us today to schedule your evaluation for any of our quality pain management services.