Spinal Cord Stimulation Specialist
- Spinal Cord
What is spinal cord stimulation?
Spinal cord stimulation is a treatment for pain that uses tailored electrical fields to block nerves from conveying pain impulses up the spinal cord to the brain. Spinal cord stimulation, also called neurostimulation, achieves this by placing small wires with electrodes in the epidural space.
The exact position of these electrodes combined with the appropriate type of electric field is key to success. The wires are connected to a small, “pacemaker-like” device called an IPG that is implanted either in the flank or buttock and has a rechargeable battery charged from the external surface of the skin. The IPG is also infinitely reprogrammable via a wireless interface, so that the settings can be constantly adjusted to keep up with changes in the pattern of the patient’s pain.
- Spinal Cord Stimulation Work
How does spinal cord stimulation work?
The spinal cord ends at the L1 vertebral body level and is located inside of the membrane that contains the spinal fluid (the dura). Most spinal cord stimulator leads are inserted below T12 and threaded up the space in the spine that is outside of the dura (the epidural space). Other spinal cord stimulators are placed in the epidural space and exit the neuroforamen to target specific areas of pain. Sometimes patients develop a resistance to the stimulation over time (much like with medication). If this occurs, the implant can be easily removed without damaging the structures of the spine.
Spinal cord stimulation is done to manage chronic pain that hasn’t responded to other treatments. It helps reduce the need for opioid medications and improves the quality of life for patients with chronic pain conditions.
MRI-Compatible Spinal Cord Stimulators
Newer spinal cord stimulators are being designed to be able to absorb the energy of an MRI and are therefore considered “MRI compatible.” These newer stimulators can only handle lower energy MRI scanners that are 1.5 Tesla or less in magnetic field strength. As the technology improves, these devices are becoming safer and more effective at containing the pain impulses in the spinal cord.
- Medications & Improves
Why Is It Done?
Spinal cord stimulation is done to manage chronic pain that hasn’t responded to other treatments. It helps reduce the need for opioid medications and improves the quality of life for patients with chronic pain conditions.
What Conditions Do Spinal Cord Stimulation Treat?
- Complex regional pain syndrome
- Treatment of refractory angina
- Chronic inoperable limb ischemia
- Painful diabetic neuropathy
- Leg-dominant failed-back surgery syndrome
- Trial and Implantation
Spinal Cord Stimulation
Trial
Before permanent implantation, a trial period is conducted where temporary electrodes are placed to assess the effectiveness of SCS. This trial lasts 1-2 weeks, allowing patients to experience potential pain relief before committing to the permanent device.
Implantation
If the trial is successful, the permanent IPG device is implanted. The procedure involves placing electrodes in the epidural space and connecting them to the IPG, which is typically implanted in the flank or buttock.
- Spinal Cord
Who are the candidates for spinal cord stimulation?
Not everyone with chronic pain is a candidate for spinal cord stimulation therapy. Candidates for spinal cord stimulation generally have chronic pain in their arms, legs or back that has lasted for six months or longer. Their pain is “neuropathic,” meaning that it produces a burning, tingling, or numb sensation; and they have not found adequate relief with other treatment options.