Spinal Cord Stimulation
Spinal cord stimulation is most commonly used for patients with failed back surgery syndrome, but can also be used for a number of other problems. These include damaged nerves in the back as with lumbar radiculopathy, herniated or degenerated discs, complex regional pain syndrome or CRPS, peripheral neuropathy like occurs with diabetes, peripheral vascular disease, post-herpetic neuralgia, and phantom limb pain. In this procedure, electrodes are placed into the spinal space through a needle, secured to the skin usually with tape, and connected to an external battery. The battery is programmed to deliver specific electrical impulses, tailored to the patient’s pain pattern. During the trial period, usually lasting several days, the patient assesses their pain and functioning. The patient is then seen for an office visit at the end of the trial period, at which time the trial electrodes are painlessly withdrawn, without sedation or sutures to be removed. Typically, if the patient has more than 50% relief, the trial is considered successful and would choose to move on to spinal cord stimulator permanent implant. later when the leads are removed.
Spinal cord stimulator permanent implant is done only after a successful temporary trial. This is an outpatient procedure, usually taking 30 and 60 minutes, depending on the patient’s specific anatomy. Typically, 2 small incisions are made, each about 2 inches, one for the electrodes to be placed and anchored permanently to the back of the spine, and a second for the battery. This is not typically a painful procedure, though the physician will usually prescribe medications he states the patient needs postoperative pain control. Spinal cord stimulator batteries can be rechargeable or non-rechargeable, but each lasts several years before needing to be replaced. The electrodes are meant to be used as long as the patient needs the spinal cord stimulator for pain control.