What is Spinal Cord Stimulation?
As a spine surgeon, Dr. Braxton helps treat patients diagnosed with a range of spinal conditions and chronic pain. For patients with chronic pain, Dr. Braxton may prescribe the use of advanced pain management technology known as spinal cord stimulation. Chronic pain is defined as persistent pain lasting longer than six months. This type of pain is no longer a symptom of the injury but rather a neurological condition requiring a specific neurological course of treatment.
Spinal cord stimulation is an advanced pain relief technology used to treat chronic pain. It is designed to block the sensation of chronic pain in the nerves branching to the back, arms and legs. The spinal cord stimulation delivers a continuous low-dose electrical current to the spinal nerve to halt the pain sensation. This device is implanted in the patient and modulated to stimulate the specific nerves of the spine responsible for the chronic pain condition. Depending on the patient’s level of pain and cause of pain, the spinal cord stimulator has:
- Low dose using implanted power source
- High dose using external power source
- Rechargable with a longer lasting power source
Once implanted, the spinal cord stimulator begins to deliver the electronic pulse that provides chronic pain relief. The pain signal at the nerve is interrupted. Patients begin to experience a reduction in the pain sensations that had been constant and a sense of relief is experienced. A life with relief from chronic pain becomes a possibility for the majority of spinal cord stimulator patients.
How Does a Spinal Cord Stimulator Work?
Dr. Braxton may recommend the use of a spinal cord stimulator for patients who have experienced ongoing pain for six months or longer. As chronic pain is no longer a symptom of an injury but rather a nerve condition, spinal cord stimulation is considered a neurological treatment. It is often recommended for these chronic pain sensory conditions:
- Complex regional pain syndrome
- Arachnoiditis – inflammation of the arachnoid
- Failed back syndrome
- Lumbar or cervical post laminectomy syndrome
- Neuropathy
In these conditions, nerves have been impacted such that they signal abnormal sensations that can include pain, burning, stinging, tingling, twitches, spasms, weakness, changes to the skin and paralysis. In every case, there is no known cure to relieve these neurological symptoms. Non-surgical treatments may provide some relief, however, the benefit of the spinal cord stimulator — to interrupt the nerve signal at the point of origin, is a welcome treatment for patients with chronic pain and neurological anomalies. Although the exact mechanism of the spinal cord stimulator is not fully understood, its effective use and long history of helping patients with chronic pain is well documented.
How is a Spinal Cord Stimulator Implanted?
Dr. Braxton provides a trial procedure for patients eligible for a spinal cord stimulator implant. The trial phase involves implanting a temporary lead, or tubing, done with a local anesthetic. The leads are connected to a trial external spinal cord stimulator that is programmed to signal the specific location of the nerve causing the pain. This temporary trial helps Dr. Braxton evaluate the effectiveness of the treatment. It provides a period of time to modify the system for optimal pain relief. Once the trial is completed, it can be determined if a permanent device is recommended.
If the trial is effective, a permanent system can be implanted. Although it is referred to as “permanent,” the treatment can be reversed at any time including turning it on and off and removing it. To implant a permanent spinal cord stimulator, patients are usually under general anesthesia, particularly when surgical leads are indicated. The exact spinal location of the leads is a function of the patient’s pain source; leads are inserted in the epidural space above the affected area of the spinal cord. The accompanying power source generator is also implanted, usually in the buttock or abdominal region. After the device has been connected, modifications to the system are completed to ensure it is working effectively and the surgery is finalized. Patients typically experience a spinal cord stimulator implant as an outpatient procedure, however, in some cases a one day hospital stay may be indicated. Patients are released with complete instructions for home care and recovery.
What is the Recovery Like After Spinal Cord Stimulator?
Dr. Braxton works closely with patients on what to expect after spinal cord stimulator implant surgery and carefully monitors progress. The immediate recovery requires pain management from the surgical procedure. Patient’s report relief from chronic pain soon after the procedure. This is the time to be cautious and follow Dr. Braxton’s instructions, avoiding too much activity, too soon. Avoid motion that cause discomfort including lifting heavy objects, bending, twisting or stretching. Sponge baths are recommended for the immediate period with normal bathing at Dr. Braxton’s instructions. Avoid any further medical treatments in this time frame and in patients using a rechargeable device, wait for staple removal before recharging.
Follow good health protocol for sleep, nutrition and use of medications. Do not remove bandages before instructed. Contact Dr. Braxton if there are any signs of infection including redness, increased pain at the incision site, drainage or fever. Follow-up appointments are used to evaluate the stimulator settings to ensure optimal functioning. Follow instructions on the use and management of your spinal cord stimulator systems and contact Dr. Braxton with any changes or questions.
How Long Does a Spinal Cord Stimulator Work?
Dr. Braxton monitors patients with spinal cord stimulator implants for optimal function for the life of the implant. For patients requiring a long course of pain treatment, replacement of the power source may be required. Systems with a traditional power source may need to be replaced within two to five years depending on the frequency of use. Rechargeable systems may need replacement within eight to ten years dependent on the frequency of recharge and usage. Daily recharging is the typical recommendation.