Spinal Cord Stimulation
Spinal cord stimulation patients use an implanted device to send electrical signals to the spinal cord in order to provide pain relief. The stimulator is activated by the patient using a remote control that triggers the implanted device to send electrical signals to the spine. The internal stimulator consists of electrodes placed near the spinal cord and a small battery pack that is often placed in the abdomen or the buttock.
This treatment method is often used when nonsurgical treatment options have proven ineffective at reducing pain.
Spinal cord stimulation is used to treat several conditions that lead to chronic pain, including post-surgical pain, inflammation, peripheral vascular disease, neuropathy, post-amputation pain, and other types of pain causing conditions. When other surgical options to treat back pain are not successful, back pain can be treated by spinal cord stimulation. Arachnoiditis, pain caused by inflammation of the membrane that covers the brain and spinal cord can also be treated using this procedure. Likewise, patients suffering from certain types of abdominal pain such as visceral and perineal pain may also benefit from spinal cord stimulation.
During the Procedure
Implantation of the device usually is performed in two phases, the first of which is a trail period. During the trial period a temporary device is implanted using a type of x-ray technology, known as fluoroscopy, as a guide to assist in the proper placement of the electrodes into the spine. During the trail phase the battery pack remains on the outside of the body and is usually worn on a belt around the waist. Then, pain levels are tracked for a period of time after implantation. If the patients’ pain is significantly reduced by the device, a permanent option may be considered. However, if a satisfactory level of relief is not reached with the temporary device, it can be removed without injury to the spinal cord and nerves.
For those who move on to the second phase, which involves implanting a permanent device, another surgery is required but this is usually performed as an outpatient surgery. During the procedure the previous electrodes are replaced and secured more permanently in the affected area to prevent shifting. The battery pack is also implanted beneath the skin at this time. All together the procedure takes a couple hours, during which the patient may remain awake to help the surgeon to ensure proper placement of the electrodes into the spine to provide the most relief.
Usually patients are released the day of the procedure with certain restrictions. Patients may be asked not to perform certain movements that are likely to pull at the incision sites, such as stretching and twisting, for a period of time following the procedure. Most patients return to work, with their surgeon’s approval, within a couple of weeks following the procedure.
Side Effects and Complication
As with any surgery, some complications are possible these include bleeding and infection at the site of the incision. Another possible complication includes, instances where the electrodes shift from the intended location, reducing the level of pain relief. In these instances, additional surgery may be required to return the electrodes to their original location. If the stimulator breaks, due to a fall a new device may need to be re-implanted. In some instances, the dura mater that surrounds the spinal cord may be punctured by a needle or electrode during the surgery resulting in leaking spinal fluid. Consequently, severe headaches may occur. Also, trauma to the spinal cord that may result in paralysis may occur during surgery; although, this complication is rare.
Driving and operating heavy machinery are not recommended when using a spinal cord stimulator. The device should be switched off before performing these activities.