Spinal Cord Stimulator
How does a Spinal Cord Stimulator work?
A Spinal Cord Stimulator can be thought of as a "pacemaker" for
pain. That is, a small implanted device carries tiny electrical
current to thin electrical leads (very thin, flexible plastic coated wires) which are placed into an area in the spinal canal above the spinal cord called the epidural space. These tiny currents stimulate nerves which then send signals to the brain that in effect modify the pain signals and replace pain with a mild, non-painful tingling sensation. This tingling sensation is generally quite mild and over
time may become imperceptible.
When other therapies and surgeries fail to control pain, when surgery is not indicated, or when a patient has other medical reasons that surgery cannot be performed, spinal cord stimulation may be a valuable option to control pain. It is also useful for
conditions where no effective surgery or other treatment exists. Additionally, there is the added benefit that the device may be temporarily tried in order to see how well it works in any patient prior to implantation.
The Trial Period
To trial the treatment, the leads are placed into the epidural space
through a needle and guided to a specific site to provide stimulation
of nerves specific to your area of pain. This is a short procedure
which allows temporary placement of the leads without implanting
the small electrical "pulse generator/battery" under the skin. The
leads are then anchored to the skin with one or two sutures and a
small dressing is applied to the skin over the exiting leads. The
leads are then attached to a small device about the size of a silver
dollar that is worn under clothes on a thin, light velcro belt. The
patient is discharged home shortly after the procedure, and trials
the device for several days to see how well their pain is controlled
with every day activity. The patient will return to the physican's
office after a several day trial period, and the leads are easily
removed in a matter of seconds after simply cutting the sutures
which hold them to the skin. This short procedure is done without
any incision under local anesthesia or mild sedation.
If the trial was successful in significantly reducing a patient's pain,
the patient may opt to return to the operating room to have the
leads and "signal generator/battery" inserted permanently under
the skin in a location where it will not be noticed or obtrusive,
generally under the upper buttock.