Spinal cord stimulation is a safe and highly effective treatment modality used for those patients who suffer chronic spine and radicular pain, post spinal fusion and laminectomy pain, and chronic nerve pain. Spinal cord stimulation blocks the transmission of pain signals between the central nervous system and the periphery where pain is felt. This is accomplished through the use of low voltage electrical stimulation applied to sensory nerves located in the epidural space. Patients often liken spinal cord stimulation to an internal TENS unit, and often report a mild tingling sensation in the area where pain is felt. While pain signals are chronically blocked, patients are often able to decrease usage of pain medications.
There are two required phases that occur prior to long-term treatment with spinal cord stimulation. The first involves a seven-day trial, where a temporary stimulator is placed in a 30 minute outpatient procedure. Patients return home following the procedure and are encouraged to maximize activities with the hope that baseline pain will be reduced during this seven-day trial phase. Following the seven-day trial, patients return to the office where the trial system is removed, and relief is assessed.
Following the trial phase, patients who respond with 50% or more improvement in pain, along with a reduction in medication usage and an improvement of activities of daily living may proceed to permanent implantation.
Typically, most spinal cord stimulation equipment consists of the following:
- An implantable pulse generator with battery that creates electrical pulses.
- A lead with a number of electrodes (4-16) that delivers electrical pulses to the spinal cord.
- An extension wire that connects the pulse generator to the lead.
- A hand-held remote control that turns the pulse generator on and off and adjusts the pulses.