What is a spinal cord stimulator?
A spinal cord stimulator is one of the spinal cord stimulation devices that is implanted into the spine to relieve chronic pain.
How does a spinal cord stimulator work?
Using electrodes, spinal cord stimulation systems deliver electric pulses into the epidural space where the affected nerves attach to the spinal cord. The electric pulses intercept the pain impulses and modify the signal to the brain to reduce pain. A small battery is implanted in the hip/buttock area to power the electrodes.
Benefits of Spinal Cord Stimulation
Spinal cord stimulation offers a range of benefits for individuals suffering from chronic pain. One of the primary advantages is effective pain relief, especially for those who have not found success with other treatments. By intercepting pain signals before they reach the brain, spinal cord stimulators can significantly reduce discomfort and improve daily functioning.
Another key benefit is the potential to reduce medication use. Many patients find that they can decrease or even eliminate their reliance on pain medications, which often come with undesirable side effects. This reduction in medication can lead to a healthier, more balanced lifestyle.
Improved quality of life is another significant advantage. With reduced pain, patients can return to their normal activities, enjoy hobbies, and engage more fully in social interactions. The minimally invasive nature of the procedure, requiring only a small incision, means that recovery is typically swift, allowing patients to resume their routines with minimal disruption.
Additionally, spinal cord stimulation is both adjustable and reversible. The device can be fine-tuned to meet individual needs, and if necessary, it can be removed, offering flexibility and peace of mind for patients.
Who can benefit from the procedure?
Spinal cord stimulation may be an effective option for patients who experience chronic pain but who have not benefited from other non-surgical treatment methods. Ideal candidates include those suffering from chronic back pain and leg pain, particularly when other treatments have failed. Ideal candidates include those with radicular or neuropathic pain resulting from injury to a nerve or nerve root, amputees with phantom pain, and patients with Regional Sympathetic Dystrophy Syndrome or Complex Regional Pain Syndrome. Patients with persistent spinal pain syndrome, often related to failed back surgery syndrome, may also benefit from this procedure.
To find out if you can benefit from a spinal cord stimulator, contact an experienced pain management doctor like those at Southside Pain Specialists. We can meet with you to discuss your pain, perform a series of diagnostic tests and imaging to identify the source of pain, and establish a personalized treatment plan. Give us a call at (205) 332-3155 to learn more about spinal cord stimulation, or become a new patient by having your primary care physician complete our referral form.
Types of Spinal Cord Stimulators
There are several types of spinal cord stimulators available, each designed to address specific needs and preferences. Traditional spinal cord stimulators use a single electrode to deliver electrical impulses to the spinal cord, providing a straightforward and effective solution for many patients.
High-density spinal cord stimulators, on the other hand, utilize multiple electrodes to deliver more targeted and potent pain relief. This can be particularly beneficial for individuals with complex pain patterns that require more precise intervention.
Sub-perception spinal cord stimulators offer another innovative option. These devices deliver electrical impulses at a level below the threshold of perception, meaning patients do not feel the stimulation but still experience significant pain relief. This can be an excellent choice for those who prefer a more subtle approach.
Rechargeable spinal cord stimulators come equipped with a battery that can be recharged through the skin, extending the device’s lifespan and reducing the need for frequent replacements. Conversely, non-rechargeable spinal cord stimulators have a fixed battery life and will need to be replaced periodically, which might be a consideration for some patients.
Spinal Cord Stimulation Procedure
There are two parts to the spinal cord stimulator procedure: trial and permanent implant. The trial period is totally reversible, lasting between three to seven days. During an outpatient procedure, your surgeon will implant the stimulator device. You will then resume your daily activities and monitor your pain levels. At Southside Pain Specialists, we generally require a 50% reduction in pain during the trial period to proceed with the permanent implant.
While spinal cord trauma is extremely rare, it is a potential complication that requires careful management during the procedure.
If spinal cord stimulation successfully reduced your level of pain during the trial period, you can undergo another outpatient procedure to have the device permanently implanted. Patients can go home immediately following the procedure but must refrain from bending, lifting, or twisting for 6-8 weeks. We will provide you with a back brace to assist in immobilization.
At Southside Pain Specialists, spinal cord stimulation is one of our most commonly performed procedures. Schedule a consultation using the form below to determine if this procedure is right for you.
What to Expect During and After the Procedure
During the spinal cord stimulator implantation procedure, you will be given local anesthesia to numb the area where the device will be placed. In some cases, sedation may also be administered to help you relax and remain comfortable throughout the process. The surgeon will make a small incision in your back to implant the device, ensuring precise placement for optimal pain relief.
Once the device is in place, it will be tested to confirm that it is functioning correctly and effectively intercepting pain signals. This testing phase is crucial to ensure that the stimulator provides the desired level of pain relief.
After the procedure, many patients experience immediate pain relief, although it may take some time for the full benefits to become apparent. It’s common to have some swelling and bruising at the incision site, but these symptoms typically subside within a few days.
Follow-up appointments are essential to monitor your progress and make any necessary adjustments to the device. Your doctor will work closely with you to ensure that the spinal cord stimulator is providing the maximum benefit and to address any concerns you may have.
Risks and Complications of Spinal Cord Stimulation
As with any medical procedure, spinal cord stimulation carries certain risks and potential complications. One of the primary concerns is the risk of infection, which can occur with any surgical intervention. Proper post-operative care and hygiene are crucial to minimize this risk.
Bleeding is another potential complication, both during and after the procedure. While rare, it is important to be aware of this possibility and to follow your doctor’s instructions to reduce the likelihood of excessive bleeding.
Nerve damage is a more serious but uncommon risk. During the implantation process, there is a chance of inadvertently damaging nearby nerves, which can result in numbness, tingling, or weakness. Your surgeon will take every precaution to avoid this outcome.
Device malfunction is another consideration. Although spinal cord stimulators are designed to be reliable, there is always a possibility that the device may not work as intended, leading to a loss of pain relief. Regular follow-ups and device checks can help detect and address any issues early on.
Lastly, there is a risk of an allergic reaction to the materials used in the device. If you have a history of allergies, be sure to discuss this with your doctor before the procedure to ensure the safest possible outcome.
Living with a Spinal Cord Stimulator
Living with a spinal cord stimulator requires some adjustments to ensure the device functions properly and provides ongoing pain relief. One important consideration is to avoid heavy lifting and bending, as these activities can cause the device to shift out of place. Following your doctor’s guidelines on physical activity is crucial for maintaining the stimulator’s effectiveness.
It’s also essential to avoid exposure to strong magnetic fields, such as those found in MRI machines, as these can interfere with the device’s operation. Similarly, electrical shocks, like those from lightning storms, can potentially damage the stimulator, so taking precautions during such events is advisable.
Regular follow-up appointments with your doctor are vital to ensure the device is working correctly and to make any necessary adjustments. These visits help maintain the stimulator’s performance and address any issues that may arise.
Carrying an identification card that indicates you have a spinal cord stimulator is also important. This card can provide critical information to medical personnel in emergency situations, ensuring you receive appropriate care.
By following these guidelines and working closely with your healthcare team, you can effectively manage your chronic pain and enjoy a better quality of life with a spinal cord stimulator.
- Psychological clearance is required for all spinal cord stimulator trials. This can be done at any psychologist’s office that offers an “MMPI2” test. Please check with your insurance company to be aware if this visit is not covered. This consists of a verbal and written exam and typically can cost around $250 out-of-pocket.The primary goal of spinal cord stimulation is to treat chronic pain that has not responded to other treatments.
- Prior authorization from your insurance company for the trial is required. This process can take up to 30 days as stated by most insurance companies. We will submit the prior authorization within 24 hours of receipt of your psychological clearance approval, so be sure to have your psychologist send us the results to our fax at 866-644-8086 or by email to [email protected] as soon as possible.
- Once we receive approval from your insurance company, we are able to schedule you for the trial. Your insurance company will determine the location you will have your procedure performed at, so available times for your procedure will vary depending on this information. Please call us at 205-202-5708 or email [email protected] to schedule.
- A trial lasts 3-7 days and is an outpatient procedure, so you will be able to go home the same day. You can resume normal activity for the week with the absence of showering or getting the site wet. During this time, you will assess the amount of pain relief you experience. Generally we will not move forward with a permanent implant unless you receive at least 50% pain relief. This percentage of relief will be assessed at our office at your suture removal appointment which occurs within the week following the trial. At this appointment we will also remove the leads. This is done without sedation and is typically a quick and easy appointment.
- Using the benefit assessment from the suture removal appointment, we will submit a prior authorization for your permanent implant if you received at least 50% pain relief. Again, this process can take up to 30 days as stated by most insurance companies.
- Once approval is received for your permanent implant, we can schedule your procedure. Your insurance company will determine the location you will have your procedure performed at, so available times for your procedure will vary depending on this information. Please call us at 205-202-5708 or email [email protected] to schedule.
- One week after the procedure you will need to come back for a staple removal appointment. This appointment is necessary to take your staples out so your incision can heal properly. After this appointment the process is completed!