The following material is given as general information only, and is not to be considered as medical advice or consultation.
Spinal Cord Stimulator is a specialized device, which stimulates nerves by tiny electrical impulses via small electrical wires placed on the spinal cord.
Currently, Spinal Cord Stimulator is offered to patients with chronic and severe neuropathic pain, or pain due to damaged nerve tissue, who have not responded to other treatment modalities. Spinal Cord Simulator patient selection is also determined by healthcare insurance's criteria for payment.
This device interrupts nerve conduction (such as conduction of pain signals) to brain.
It is done in two stages. In the first stage, temporary wires are placed and an external device is used by the patients to generate electrical current. If this trial is successful in relieving pain, then the permanent device is placed under the skin. Each procedure can take up to 3 hours.
The wires are placed under x-ray guidance and a local anesthetic, or numbing medicine, like novocaine, is used to numb the skin and deeper tissues.
The procedure involves inserting a needle through skin and deeper tissues (like a "Flu shot"). So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle.
The placement of the wires is done under local anesthesia with patients mildly sedated. This is necessary to ensure proper placement of the wires. The amount of sedation given generally depends upon the patient tolerance. For the generator placement, patients are given stronger intravenous sedation.
It is done with the patient laying on the stomach when placing the wires. The skin is cleaned with antiseptic solution and then the procedure is carried out. X-ray (fluoroscopy) is used to guide the needle for wire placement.
Where is the generator placed?
For the pain involving lower back and lower extremities, the wires are inserted in the midline at the lower back. The generator is then placed on the side of the abdomen or buttock. For the pain involving upper extremities, the wires are inserted in the midline at the upper back. The generator is then placed on the side of the abdomen or buttock.
If the procedure is successful, you may feel that your pain may be gone or quite less. You will experience a fairly constant sensation of stimulation. You may have soreness due to the needles used for a day or two.
This procedure is normally a day-procedure. Some patients may be kept overnight for observation. You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you.
Depending upon how much the device is used (intensity and duration), the batteries in the generator may last several years. The batteries can not be replaced or recharged.
It is very difficult to predict if the procedure will indeed help you or not. For that reason temporary wires are placed to determine if this device will be effective to relieve your pain or not. Typically, patients will have a 50 to 70 % reduction in their pain.
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. Please discuss your concerns with your physician.
If you are on a blood thinning medication (e.g. Coumadin®), or if you have an active infection going on, you should not have the procedure.
More detailed information is available from the manufacturer of this device. At the time of consultation you will receive a Spinal Cord Stimulation Patient Education Booklet. Additional information is also available at the Medtronic'sTM Web Site @ http://www.medtronic.com and Advanced Neuromodulation Systems web site @ http://www.ans-medical.com ."
Danya Godoy, M.D.
Interventional Pain Management
Suncoast Medical Clinic
620 10th Street North
St Petersburg, FL 33705