What is a Spinal Cord Stimulator?
When all other non-surgical pain treatments have failed to relieve or manage back pain, a spinal cord stimulator may be the next step, and a very good option. The stimulator is an implanted device that transmits very low levels of electricity into the spinal cord to relieve chronic pain. This electricity’s goal is to target multiple muscle groups from the spine, thereby changing how the brain senses pain.
How Does a Spinal Cord Stimulator Work?
- Spinal cord stimulators are made up of thin wires (the electrodes) and a small, pacemaker-like battery pack (the generator).
- Electrodes are placed between the spinal cord and the vertebrae (the epidural space), and the generator is placed under the skin, usually near the buttocks or abdomen
- Spinal cord stimulators give patients the ability to control the electrical impulses using a remote control when they feel pain. Both the remote and its antenna square measure outside the body.
Spinal cord stimulators are also accustomed treat or manage differing kinds of chronic pain, including:
- Back pain from failed back surgery
- Post-surgical pain
- Arachnoiditis (painful inflammation of the arachnoid, a thin membrane that covers the brain and spinal cord)
- Heart pain (angina) untreatable by other means
- Injuries to the spinal cord
- Nerve-related pain (such as severe diabetic neuropathy and cancer-related neuropathy from radiation, surgery or chemotherapy)
- Peripheral vascular disease
- Complex regional pain syndrome
- Pain after an amputation
- Visceral abdominal pain and perineal pain
Should You Consider a Spinal Cord Stimulator?
Spinal cord stimulation is generally recommended to work in tandem with other pain management treatments, including medications, exercise, physical therapy and relaxation methods. This type of stimulation can be effective in improving overall quality of life and sleep, and reduce the need for pain medicines.
As with all treatments, your specialist will want to make sure spinal cord stimulation is right for you — and that it is likely to provide significant relief from your chronic pain.
Each patient is different, but generally people who benefit the most from spinal cord stimulation are those who:
- Have not experienced pain improvement with medications, less-invasive therapies or prior surgeries
- Do not have psychiatric disorders
The Three Main Types of Spinal Cord Stimulators:
- Conventional implantable pulse generator (IPG) is a battery-operated spinal code stimulator. This device may be a viable selection for patients with less severe pain as it has a lower electrical output to address it. When the battery runs out, an additional surgery is required.
- Rechargeable IPG works similar to the conventional device, with the difference that the battery can be recharged without another surgery. Because the energy supply is reversible, these stimulators can put out more electricity. This may be a better choice for people with pain in the lower back or in one or both legs, as the electrical signal can reach further.
- Radiofrequency stimulator uses a battery that’s outside the body. This stimulator is never used these days as a result of newer styles and higher technology. It has reversible batteries, and like the rechargeable IPGs, it may be better for people with pain in the lower back and legs because of the device’s power.
Spinal Cord Stimulator Surgery
Spinal cord stimulators need a total of two procedures to check and implant the device: the trial and also the implantation.
- This trial procedure typically requires only one incision in the lower back to place the electrodes
- The generator/battery are outside the body, typically on a belt worn around the waist
For about a week, you will evaluate how well the device reduces your pain. The trial is considered a success if you experience a 50% or greater reduction in pain level. If unsuccessful, the wires can easily be removed in the clinic without damage to the spinal cord or nerves. If a measurable amount of pain reduction is experienced and deemed a success, surgery is scheduled to permanently implant the device.
Spinal Cord Stimulator Implantation
During the permanent implantation procedure, the generator is placed underneath the skin and the trial electrodes are replaced with sterile electrodes. Unlike the trial electrodes, these will be anchored by sutures to minimize movement. The implantation can take about one to two hours and is typically performed as an outpatient procedure.
Spinal Cord Stimulator Recovery
Most patients leave the same day as their procedure when the anesthesia has safely worn off. Your surgeon will discuss your recovery plan, but generally lighter activity is recommended for about 2 weeks after surgery.
Once your operating surgeon approves you for normal activity, you’ll be able to drive once more (with the stimulator turned off).
This is typically one to two weeks after surgery.