What is a Spinal Cord Stimulator?
A Spinal Cord Stimulator is a specialized device, which stimulates nerves by tiny electrical impulses via small electrical leads placed in a space outside of the spinal cord. This procedure attempts to convert the painful sensation to a tingling sensation, which the brain perceives as more desirable. Small leads with multiple electrodes are positioned over the spinal cord
How does this procedure different from Spine Surgery?
A spinal cord stimulator differs from traditional surgery in several ways. The spinal cord stimulator does not change the underlying condition or manipulate your bones; it simply changes the brain’s perception of pain. There are two parts to the surgery. There is a trial phase in which the leads are placed and connected to an external power supply. You will go home for 5 to 7 days and see how well the device controls your pain. After the trial phase is complete, the leads are removed completely and you will have a discussion with your physician on the next step of your care.
How long does the procedure take?
It is done in two stages. In the first stage, temporary leads are placed and an external battery is used to generate the electrical current. This first stage is called a spinal cord stimulator trial. It usually lasts 5 to 7 days; at the end of the trial the device is removed in clinic. If the trial is successful in relieving pain, then the permanent device is placed under the skin surgically at a later date. The trial procedure typically takes about 45 minutes and the implant procedure takes typically about 1 1⁄2 hours.
How is it actually performed?
The leads are placed under x-ray guidance and a local anesthetic like lidocaine is used to numb the skin and deeper tissues. The procedure is performed in the operating room to maintain sterility. The patient will have IV sedation and analgesia.
How is the injection performed?
The procedure is performed with the patient lying on the stomach, under x-ray control. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. The skin in the back is cleaned with antiseptic solution and then the injection is carried out. After the injection, you are placed on your back or on your side.
Where are the leads inserted? Where is the generator placed?
For the pain involving lower back and lower extremities, the leads are inserted midline in the lower back region. The generator is then placed in the soft tissue of the gluteal region near the hip. For the pain involving the neck and upper extremities, the leads are inserted in the midline at the upper back. The generator is then placed along the middle or lower back.
What should I expect after the procedure?
After the procedure you may feel that your pain may be gone or significantly lessened. You will experience a fairly constant sensation of stimulation; and will be given multiple programs of stimulation that will be individualized to your liking and activity level. You will have soreness due to the needle placement in your back.
What should I do after the procedure?
This procedure is normally a same day-procedure. We advise the patients to take it easy for a day or so after the procedure. You will be provided with a post procedure information sheet regarding wound care and physical restrictions amongst other topics.
What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. Please discuss your concerns with your physician.
Where can I get additional information?
More detailed information is available from the manufacturer of this device. At the time of consultation you will receive a Spinal Cord Stimulation Patient Education Booklet.