Spinal cord stimulation is a procedure that requires the placement of an electrical lead or leads into the epidural space. The electrical lead is then used to stimulate the spinal cord in hopes of replacing the painful sensation with a non-painful tingling-type sensation. The procedure is usually begun with a trial process where electrodes are placed temporarily, and the patient is provided a battery pack to try the stimulation out for four to five days. After the trial period, the electrode or electrodes are removed, and a discussion with your physician ensues as to whether or not full implantation is indicated.
One of the most common reasons for using spinal cord stimulation is leg pain that persists after spinal surgery. Also, the procedure has shown promising results with complex regional pain syndrome.
The exact mechanism of spinal cord stimulation is not known. However, it does appear that facilitation of pain modulating effects does dampen pain transmission.
The success rate of spinal cord stimulation in cases such as failed back surgery syndrome appears to be approximately 65%. In patients who suffer from complex regional pain syndrome, success rates have been found to be somewhat higher.
The trial procedure is performed in our office setting. This is usually an approximately 1½-hour procedure, including recovery time, and the patient is then dismissed to home in hopes of trying the product for three to four days. If the trial is successful, plans are then made for implantation which usually occurs within the next one month after the trial period. Implantation is performed at a local community hospital and is an outpatient surgery.
As with any procedure, there are certain risks which include but are not limited to bleeding, infection, headache, worsening of pain, and failure to cover pain.
Several of our physicians at Pain Management Associates are trained in this modality and would be happy to answer any questions.
References: Pain Management Secrets, by Charles E. Argoff MD, Gary McCleane MD. Mosby; (July 27, 2009)