A spinal cord stimulator implant is a device that is implanted in the body to help manage chronic pain. The device works by sending electrical impulses to the spinal cord to replace or alter pain signals before they reach the brain. The spinal cord stimulator helps lower pain levels by 50% to 70% reducing the need for pain medications. A spinal cord stimulator may be used to treat pain due to conditions such as sciatica, complex regional pain syndrome, failed back surgery syndrome, peripheral vascular disease and multiple sclerosis.
Video Transcript
Spinal cord stimulation for chronic back pain uses electrical pulses to stimulate nerves in the spinal cord, with the goal of interfering with the path of pain signals as they travel to the brain.
The first step in the process is a trial period of spinal cord stimulation.
The person is sedated, given a local anesthetic, or both. Next, thin wires with electrodes attached—called leads—are inserted into the space surrounding the spinal cord via a thin hollow tube.
The area where the leads are placed is called the epidural space.
Next, the leads are attached to a generator outside the body.
The patient is then awakened and asked to give feedback on where additional current is needed for pain control. Adjustments are made by the doctor to ease all the pain, and the person is again sedated.
Next, the tube is extracted, and the leads are left in place. The person then tries spinal cord stimulation for several days.
If the person decides that the trial has provided sufficient pain relief, the next step is to implant a permanent spinal cord stimulator.
Permanent implantation is similar to the trial period process, but with some extra steps.
First, an incision may be made to allow removal of part of the lamina—a small bone over the back of the spinal cord. This makes room for the larger leads often used in permanent spinal cord stimulation.
Once the leads are in place, the person is awakened and asked to provide feedback on whether all areas of pain are covered. When coverage is complete, the person is sedated again.
Next, the surgeon creates a pocket between the skin and the muscle in the upper buttock or chest, and implants a small generator.
The leads are then tunneled to the generator, allowing current to flow.
After the procedure, the doctor programs a small hand-held controller that sends signals to the generator. The patient can then adjust the type of pain relief needed for various situations.
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SURGICAL VIDEO
Implantation of a Thoracic Spinal Cord Stimulator Paddle Electrode and Generator Under General Anesthesia With Intraoperative Neuromonitoring: 2-Dimensional Operative Video
Stone, Lauren E BA,,; Falowski, Steven M MD
Department of Neurosurgery, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
Department of Neurosurgery, St. Luke's University Health Network, Bethlehem, Pennsylvania
Correspondence: Lauren Stone, BA, 701 Ostrum Street, Suite 302, Bethlehem, PA 18015. E-mail: [email protected]
doi: 10.1093/ons/opy281
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