What is a spinal cord stimulator?

03 Oct What is a spinal cord stimulator?

Spinal cord stimulator is a battery-powered electrical device. It has a pulse generator connected to electrode leads that deliver electrical impulses to the spinal joints. A small remote control helps operate the device and perform spinal cord stimulation.

When was spinal cord stimulation therapy introduced?

The FDA approved spinal cord stimulation therapy for pain relief in 1984.

How big is a spinal cord stimulator?

A spinal cord stimulator is similar to a stopwatch in size.

How often do I need to replace the battery?

You may need to replace battery of a spinal cord stimulator 5 to 10 years, subject to how many times and how long you use it each day.

How does a doctor assess the suitability of a patient for spinal cord stimulation?

Anyone suffering from chronic neck pain after surgery and getting no benefit from other treatment methods can consider spinal cord stimulation. Doctors carry out a trial to check his or her suitability for the permanent implant.

The spinal cord stimulator is placed in a belt wrapped around your waist. A catheter connecting the device delivers electric impulses to the spine. The catheter is inserted in an outpatient procedure performed under local anesthesia.

The trial goes on for a week and the failed neck surgery syndrome patient is considered for permanent spinal cord stimulator implant if there is at least 50% pain relief without any side effect.

What happens during spinal cord stimulator surgery?

Spinal cord stimulator implant surgery requires 2 to 3 hours and the patient is sedated with general anesthesia. Doctors create a small place for the device just above the buttocks. Electrode leads are placed using a small incision. Both the device and the leads are connected using a small wire passing through soft tissues. Incisions are closed after the functions are confirmed.

What can I expect after the implant?

Spinal cord stimulator implant is an outpatient procedure and no need for overnight hospital stay except in rare cases. Discomfort and soreness are common after the implant and last for a few days.
No intense activity or twisting of body is allowed for 6 weeks. It is suggested not to drive for 4 weeks.

Is there any threat to the spinal cord in the long run?

Spinal cord stimulation does not cause any damage to the spine. The implant procedure when not performed by an expert surgeon is likely to cause some surgical complications.

How does a patient feel during spinal cord stimulation?

Patients may feel a sensation when the device is in neuromodulation mode or providing stimulation therapy. The intensity of the sensation can be adjusted.

Does spinal cord stimulation therapy eliminate the source of neck pain?

Spinal cord stimulation helps mask the pain and ensures significant and sustained reduction of pain symptoms felt after failed neck surgery. However, it does not eradicate the source of pain.

Will others be able to notice the spinal cord stimulator?

No, neither the implant placement is visible nor it creates enough noise so that others can listen.

How is the spinal cord stimulation controlled?

A small remote device is used to control, adjust, switch on, switch off, and program the spinal cord stimulator implanted. More advanced devices with auto-adjustment mode are also available.

How often should I need to visit the doctor?

You may need to visit your doctor more frequently for the first two months after the implant surgery to make frequent adjustments to the stimulator. Thereafter, you may reduce the frequency of visit to once in six months.

Does my insurance cover the costs of spinal cord stimulator implant?

Though most insurers provide coverage, it differs from company to company and the plan you have. Check with your insurer if you have complete or partial coverage.

What are risks associated with spinal cord stimulation?

Spinal cord stimulation is safe to treat failed back syndrome. However, there can be rare side effects, such as infection, surgical complications, fibrosis, and cerebrospinal fluid leak leading to spinal headache.

References

Vallejo R, Kramer J, Benyamin R. Neuromodulation of the Cervical Spine Cord in the Treatment of Chronic Intractable Neck and Upper Extremity Pain: A Case Series and Review of the Literature. Pain Physician. 2007 Mar;10(2):305-11.
Jeon YH. Spinal Cord Stimulation in Pain Management: A Review. Korean J Pain. 2012 Jul; 25(3): 143–150.
Kim JK, Hong SH, Lee J-K. High-Level Cervical Spinal Cord Stimulation Used to Treat Intractable Pain Arising from Transverse Myelitis Caused by Schistosomiasis. Journal of Korean Neurosurgical Society. 2010;47(2):151-154.
Chivukula S, Tomycz ND, Moossy JJ. Paddle lead cervical spinal cord stimulation for failed neck surgery syndrome. Clin Neurol Neurosurg. 2013 Oct;115(10):2254-6.
Chivukula s, Tomycz ND, Moossy J. Moosy JJ. Paddle lead cervical spinal cord stimulation for failed neck surgery syndrome. Clinical Neurology and Neurosurgery. July 2013;115(10)