FAQs on Spinal Cord Stimulator
FAQs on Spinal Cord Stimulator Implants
Spinal cord stimulator was first introduced in 1967. The FDA approved the device in 1989 to treat pain in the arm, leg and trunk traced to nerve damage. At present, about 50,000 spinal cord stimulator implants are performed every year covering about 70 percent of neuromodulation treatments. Back pain caused by surgery accounts for the highest number of implants followed by ischemia-linked painful conditions. The top Chicago pain management doctors at Premier Pain & Spine offer these state-of-the-art implants.
What is a spinal cord stimulator?
Spinal cord stimulator is an electrical transmitter purposefully built into a medical device. Comprising a set of electrodes, the neurostimulator is implanted in the epidural space, a fluid-filled area in the vicinity of the spinal cord, to have an electromagnetic sphere. Programmed as per the patient conditions, the spinal cord stimulator generates electrical impulses that obstructs nerves carrying pain signals and hinder their perception by the spinal cord. It also stimulates better motor functions to overcome functional difficulties.
The device is found to be effective in the management of various chronic pain conditions. With the latest technological advances, a spinal cord stimulator now comes with more powerful microprocessors, improved life, more successful pain management, and precise integration.
How does a spinal cord stimulator work?
Spinal cord stimulator ensures pain management based on neuromodulation, which means “altering the nerve activity using electrical stimulation.” Electrical impulses stimulate the spinal nerves to focus on activities other than pain sensation transmission and this obstructs pain signals from being perceived.
The brain gets pain signals through Aδ and C nerve fibers. The Aβ fibers carry other non-pain sensations. Electrical signals influence the firing pattern of neural circuits and moderate their excitability while non-pain sensation is allowed to pass unhindered. Thus, pain signal is prevented from reaching to the brain and patients experience relief.
- Pain from failed back surgery
- Pain due to injured spine
- Pain from spinal stenosis
- Pain from ischemia and associated disorders
- Peripheral neuropathy pain
- Pain from diabetic neuropathy
- Chronic pain in the neck
- Chronic pain experienced in the back
- Reflex Sympathetic Dystrophy
- Pain due to atypical sympathetic response to tissue injury
- Sciatica pain affecting the back and leg
- Pain from abdominal nerve compression
- Complex Regional Pain Syndrome
- Pain from vertebra surgery
- Chronic pelvic pain
- Pain following central nervous system injury
- Pain from disk degeneration and claudication
How effective is spinal cord stimulator therapy?
- Multiple studies indicate benefits of spinal cord stimulator for patients with back and neck pain when surgery is not a viable option. Manufacturers claim up to 80 to 85 percent pain relief. Studies indicate between 70 percent (Neurosurgery, 2006) and 88 percent (Pain, 2004) success rate based on patient conditions.
- The method may result in more than 60 percent pain relief for those having chronic back pain when observed for 15 years after the implant. The efficacy for 20 years is pegged at 50 percent. For those with diabetic neuropathy pain, the benefits are as high as 85 percent.
- At least 80 percent patients do not require to have analgesic medication to control pain after having spinal cord stimulators implanted. (Spine, 2005)
Who is a candidate for spinal cord stimulator implant?
Spinal cord stimulator is widely considered as a second-line pain management procedure. It means doctors suggest the implant only when patients complaint of no significant pain relief from medication, surgery, or other treatment methods. Many see it as a less-invasive alternative to surgical treatment. Patients must be in good physical and psychological state and do not have any condition that may endanger their lives following the implant.
Spinal cord stimulator therapy may not be suitable for those taking blood thinners, high on diabetes, have ongoing infections, already using pacemakers, or treated with therapeutic electromagnetic currents or ultrasound.
How is a spinal cord stimulator implant performed?
Chicago pain doctors implant a spinal cord in two stages – trial and permanent implant. The trial stage is done to see if the method is beneficial for a particular patient without side effects. If it is found to be successful, the permanent implant is done.
Why is the trial a must before implant?
The spinal cord stimulator trial has two objectives – first, to assess the potential benefits and risks and second, avoid the high cost and inconvenience to patients who may not get benefits for it. The device costs over $10,000 and implant has certain hassles too. Unless a trial is done, patients not being benefited from it may have to undergo a second surgery for removal and also lose a big amount of money.
What is done during the trial?
- It takes about 90 minutes to perform the trial phase.
- Patients sleep in a prone position following IV administration.
- The skin above the lumbar spine is numbed and needle is introduced close to the spine.
- A catheter is put through the needle. It is attached with a stimulator wrapped around patient’s waist.
- Electrical impulses administered through the catheter.
- The stimulator is programmed in different modes to monitor pain relief.
- If there is continued and significant pain relief for a week, doctors give green signal to a permanent implant.
How is a spinal cord stimulator implant performed?
- Based on trial results, the spinal cord stimulator is programmed.
- Patients have general anesthesia and are asked to sleep on their stomach.
- A small surgery is done to make adequate space for the device in the lower spinal area just above the buttock. A small area is cleared of bony parts.
- The spinal cord stimulator is placed into the created space and a catheter lead is attached to it. The catheter is placed in between soft tissues to ensure that it remains undisturbed.
- A test run is done before the incision is closed and bandaged.
- The entire implant takes about 2 hours
What should I expect after spinal cord stimulator implant?
Patients are discharged after an overnight stay for monitoring of vital parameters. Implant site soreness may be there for week. Take rest for a week and avoid bending or twisting for six weeks. You can return to work, but suggested to avoid stressful activities for six weeks. Patients experience immediate pain relief that stabilize with permanent effect in 2/3 days.
How Long Does Spinal Cord Stimulator Implant Last?
A spinal cord stimulator goes relieving pain on for years. Patients can go for those with internal or external batteries. A stimulator with internal batteries is replaced once in a few years.
What are side effects of spinal cord stimulator?
Implant may cause bleeding, temporary numbness, soreness and other surgical complications. Unless carefully monitored, there may be the risk of infection. There are rare cases of stimulator rejection, migration, nerve damage or device wearing off earlier than expected.
Premier Pain & Spine offers spinal cord stimulator implants for patients with chronic pain that is not amenable to surgery and as a last resort. For the top pain management clinics in Chicago, call today!
Young Hoon Jeon. Spinal Cord Stimulation in Pain Management: A Review. Korean J Pain. 2012 Jul; 25(3): 143–150.
Tator CH, Minassian K, Mushahwar VK. Spinal cord stimulation: therapeutic benefits and movement generation after spinal cord injury. Handb Clin Neurol. 2012;109:283-96.
Song JJ, Popescu A, Bell RL. Present and potential use of spinal cord stimulation to control chronic pain. Pain Physician. 2014 May-Jun;17(3):235-46.
Taylor RS, Van Buyten JP, Buchser E. Spinal cord stimulation for chronic back and leg pain and failed back surgery syndrome: a Systematic Review and Analysis of Prognostic Factors. Spine. 2005;30:152-160.
Kumar K, Hunter G, Demeria D. Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery. 2006; 58:481-496.
Turner JA, Loeser JD, et al.: Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome: A systematic review of effectiveness and complications Pain. 2004;108:137-147