Spinal Cord Stimulator
Spinal Cord StimulatorThese procedures are generally used to treat conditions such as persistent chest pain, phantom arm or leg pain, chronic pelvic pain and other persistent nerve pain. Spinal Cord Stimulator is implemented in two parts.
In the first part, the patient carries out a trial of the Spinal Cord Stimulator whereby a (lead) will be connected to a portable external pulse generator. The patient will be given various combinations of electrical signals to assess if the pulses reduce their pain. This trial mimics the actual treatment. If the trial is successful, the entire Spinal Cord Stimulator system (including the electrodes, leads, cables and pulse generator) will be implanted into the patients. An external remote controller communicates with the (device) in order to instruct the release of pulses. The patient is subsequently monitored after the entire Spinal Cord Stimulator system is installed.
What is Spinal Cord Stimulator?
Spinal Cord Stimulator is an intervention for chronic back, leg, arm or chest pain. Its uses include other conditions, such as persistent chest pain, phantom pain of the arm or leg, failed back surgery syndrome, chronic pelvic pain and persistent nerve pain. It can be an effective alternative or adjunct treatment to other therapies that have failed to manage pain on their own. An implantable spinal cord stimulator delivers small electrical signals through a lead implanted in the epidural space. Pain signals are inhibited before they reach the brain. Instead of pain, patients may feel pain relief.
Spinal Cord Stimulator may be:
- An effective alternative when conventional therapies and systemic pain medications provide inadequate pain relief or intolerable side effect
- A reasonable alternative to consider before performing irreversible, neurodestructive surgical procedures
- Considered when there is persistent nerve type pain whereby there is nerve injury or damage.
How is Spinal Cord Stimulator done?
There are 2 parts to the therapy.
Part 1: Spinal Cord Stimulator trial
An externalised trial lead is temporarily “implanted” into the painful nerves in the first part of the trial. This is done under local anaesthesia and sedation. This lead will be connected to a portable external pulse generator. The patient will be given various combinations of electrical signals being sent to the injured nerves. This trial therapy is to mimic the actual treatment should the patient find the therapy helpful with his pain. Over a period of 3 days, the patient will have these different combinations of electrical stimulation to assess how they cover the painful area. If the patient finds that it improves the pain by more than 50% or up to 75%, this is considered a successful trial and we will proceed to part 2.
Part 2: Spinal Cord Stimulator implantation
The entire Spinal Cord Stimulator system, which includes the electrodes, leads, cables and pulse generator, will be implanted into the patient. The entire process will be done under general anaesthesia. All the implants and parts will be implanted under the skin. The pulse generator will usually be placed in the right or left lower flank, so that an external remote controller will be able to communicate with the device to instruct it accordingly. There, stimulation can be used for 24 hours every day to provide continuous pain relief, stopping only for recharge.
The patient will go back to the pain specialist for calibration and monitoring regarding the Spinal Cord Stimulator use. This neuro-modulation treatment will “adjust” the injured nerves and give effective pain relief.
In the newer models, the pain relief can be provided even without the presence of paraesthesia or tingling sensation.