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Spinal Cord Stimulation

Spinal cord stimulation is used for nerve pain associated with post laminectomy syndrome, radiculopathy, complex regional pain syndrome (CRPS), phantom limb pain, or neuropathy that is resistant to medications and minimally-invasive, injection-based treatments. 

A spinal cord stimulator is a small device with electrodes (leads) that are placed in your epidural space under live x-ray guidance. The epidural space is a space that exists in your spine within the spinal canal. This space sits between two planes of tissue: the sac of tissue that houses your spinal cord (dural sac) and the vertebral bones. The epidural space contains fat tissue along with blood vessels and nerve roots.

The lead sends currents to your spinal cord that compete with the entry of pain signals. Instead of pain, you may feel a mild, pleasant tingling sensation in the area where you usually feel pain.  

How It Works

There are two phases of spinal cord stimulator implantation. First, a trial is performed to test out the device before permanent implantation.

  • The tip of the lead is placed in your epidural space. 
  • The tail is secured with tape and dressings to your back, and connected to an external controller that can increase or decrease stimulation.
  • You will be able to test this system for 5-8 days. If the spinal cord stimulator provides at least a 50% reduction of your pain and improves your quality of life, you may be a candidate for permanent implantation. If the trial does not provide adequate pain relief, the lead can be removed easily without damage to the spinal cord or nerves.

Spinal cord stimulator trials are performed under live fluoroscopic guidance to ensure the accuracy and safety of this procedure.

  • You will be asked to lie on your stomach. 
  • Your back will be cleaned with an antiseptic, and a sterile drape will be placed.  
  • Your JLR Center for Pain Medicine physician will inject a numbing medication (local anesthetic) to numb the skin. 
  • An epidural needle will then be guided to the epidural space. 
  • The lead will be placed in the epidural space under x-ray guidance. 
  • A representative of the spinal cord stimulator company will be present in the room to start stimulation and confirm the adequate coverage of your painful areas. Although you will have received conscious sedation for this procedure, you will still be able to give us feedback and also confirm proper coverage of your painful areas.

Prior to spinal cord stimulation implantation, an MRI is ordered to determine whether you have enough spinal space to have the lead placed. Also, insurance requires a psychological evaluation to help understand your needs and expectations of therapy.

Risks

The potential risks are very low, and include infection, bleeding, allergic reaction, and prolonged increases in pain. Your physician will use x-ray guidance and sterile techniques to reduce these risks, as well as to reduce the risk of nerve damage and spinal headache.