Neurostimulation therapy is most often recommended when more conservative pain management therapies have failed.
A Spinal Cord Stimulator is an implantable device that interrupts pain signals before they reach the brain, replacing them with a more pleasant sensation. A Spinal Cord Stimulator consists of stimulating electrodes, an electrical pulse generator that conducts wires or leads from the electrodes to the generator, and a remote control that lets the patient modify how the stimulation feels. It is most commonly recommended for a condition known as Failed Back Surgery Syndrome (FBSS), which affects approximately 40 percent of patients who have had previous spinal surgery.
A temporary or “trial stimulator” will be tested to determine the appropriate level in the spine to implant the electrodes and whether it will be helpful in controlling your pain. The procedure is performed on an outpatient basis under light sedation for your comfort and usually takes between one to two hours.
While lying face down on a table, the skin is cleaned and numbed with anesthetic. Your physician uses a fluoroscopic X-ray machine to help guide the electrodes to the appropriate level of the spine that will be stimulated to reduce your pain. One or more temporary leads will be inserted through an epidural needle in the epidural space of the spinal canal.
Once it is determined that the leads are at the right level, they are connected with cables to an external generator, typically worn on a belt around your waist. The external generator acts as a programmer, allowing you to control the feel of the stimulation. The trial period usually lasts from five to seven days, but can be stopped at any time. The temporary leads can be removed in your physician’s office.
If you and your physician determine the stimulator provided sufficient pain relief, the next step will be to have the system permanently implanted. The procedure may be performed on an outpatient basis. However, a short hospital stay may be recommended, depending on your physician’s preference and your insurance policy.
During this procedure, new permanent leads will be positioned in the epidural space at the level that provides maximum pain relief. Next, your physician makes a small incision to implant the electrical pulse generator below the skin, usually in the abdomen or lower back area. The leads are then tunneled under the skin to the generator, which will be programmed by an external control unit.
After the procedure you will be shown how to turn the stimulator on and off and how you can adjust the amount or intensity of the stimulation.You will also be given information on caring for your stimulator and certain activities to avoid.
For a few days after the procedure, you may experience some mild swelling and discomfort around the incision site. Although a Spinal Cord Stimulator will not cure the condition causing the pain, it has helped thousands of people significantly reduce their pain and return to their normal activities.