Spinal Cord Stimulators

A spinal cord stimulator is an advanced treatment for chronic pain. With this therapy, a small implanted device generates electrical signals within your spinal cord. Pain messages are then changed before they reach your brain. Previous areas of pain are replaced with a different sensation. Usually, patients describe this as a tingling feeling.

If you are a potential candidate for spinal stimulation, you will undergo a trial procedure. The trial determines if you are a candidate for surgical implantation. You should feel significant pain relief and feel comfortable with the sensations of the stimulation. During the trial, you will be placed face down (prone) on a procedure table and given a light sedation. You have to be awake enough to communicate with the surgeon. The surgeon will use an x-ray machine to visualize your spinal anatomy. Next, you will be given a local anesthetic to numb your skin and subcutaneous tissues. After that, a special needle will be placed just outside the spinal cord. A wire or lead will then be threaded through the needle along the spinal canal. You will then tell the surgeon where you feel stimulation, and the wire/lead will be adjusted appropriately. The needle is then pulled out, leaving the wire/lead in place. Thus, there will be a wire coming out of your skin that will be taped down. The wire will be attached to an external battery. You will then go home for several days to assess the amount of pain relief you experience. Upon return to the doctor’s office, the trial wire/lead will be pulled out.

At this point, a decision will be made on whether or not to proceed with the implantation based on the results of the trial. Spinal cord stimulators can significantly decrease pain, but as with any surgical procedure, there are risks involved. These include infection, bleeding, injury to the spinal cord, equipment failure, or future lack of benefit. You should also note that after the implantation, you will no longer be able to have a MRI. Prior to the procedure, you will be referred to a psychologist. The psychologist will assess your understanding and expectations of the implantation.

For the actual implantation, the wire/lead will be placed just as during the trial; however, the lead will be connected to a small battery placed underneath your skin. The battery is placed in either your upper buttock or abdomen. Today, most batteries implanted are rechargeable. From time to time, you will have to recharge the battery at home using a remote control device. The remote control device is placed on top of your skin, overlying the implanted battery, and the battery’s energy is restored over a few hours.

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