Article Spotlight
Spinal Cord Stimulator (SCS) in Chronic Pain Management
Spinal cord stimulator is a minimally invasive procedure that provides excellent pain relief without using strong pain medications in chronic pain situations. As it does not involve taking narcotics medication, patients can get pain relief without any alteration in their mental status.
The spinal cord stimulation procedure does involve implantation of a catheter with electrodes that are implanted in the spine. This is done in two stages.
STAGE1:
IMPLANTATION OF TRIAL SPINAL CORD STIMULATOR. During this trial, a spinal cord stimulator is implanted through the skin. This is then connected to an outside battery. Because this is considered an out-patient procedure and the patient is allowed to go home within an hour. During the trial period at home and work, the patient will be able to evaluate whether the procedure relieves his/her pain during the regular daily routine.
How it works? The spinal cord stimulator sends electrical signals to the brain through the spinal cord. These electrical signals block pain signals coming from body. Patients all of a sudden experiences pain relief. Because there are no medications administered, the patient is completely alert. He/She can do all their regular functions including driving.
If the pt finds that SCS is at least relieving 50% of his/her pain, the patient may choose to have a permanent implantation. The temporary stimulator is taken out within five to seven days.
STAGE 2:
IMPLANTATION OF PERMANENT SPINAL CORD STIMULATOR AND GENERATOR: This is also an out-patient procedure. Occasionally, patient may be admitted for overnight observation depending upon their medical condition and pain tolerance. The major difference in permanent implantation is the generator (battery). This time, the generator is implanted inside with the spinal cord stimulator.
Selection of patients: This is very important in the successful outcome of good results. SCS is indicated when all conservative treatments failed and the patient is not a candidate for any surgery that can correct the underlying problem.
The following patient’s are best benefited by SCS:
-
1. Patient’s with back pain that radiates into one or both legs.
2. Patient’s who had previous back surgery/fusion and continues to have
back pain with radiation of pain going into one or both legs.
3. Patient’s with neck pain that also radiates pain going to one or both
arms.
4. Patient’s that have cervicogenic headache’s (headache on the back of
the head and upper part of neck).
5. Patient’s that are diagnosed with Reflex sympathetic dystrophy or
complex regional pain syndrome. This may involve arms or legs.
6. Patient’s experiences pain in legs secondary to poor circulation.
In my practice only 60% of patient’s who have had the trial stimulation implantation do go on to have the permanent implantation. As I stated above, patient’s selection is very important. In our experience; all of our patient’s who have had the permanent implantation done has at least 70% pain relief. Their mobility and functionality improved significantly. Many of them who did not sleep for many years because of pain are able to sleep for the first time. The fact that they are able to sleep and rest better changed their personality. This also changed their attitude towards life. Most of them were able to stop pain medications altogether. Because they are not taking pain medication, they don't have anymore feelings of being drowsy and are able to enjoy life and family relationships better. Patient’s families observed a pleasant and dramatic change in their relationships.
To summarize, SCS provides a very effective pain relief option; without drugs, for those patients’s who have exhausted all treatments. If you would like to speak with one of our patient’s who's had this procedure done in the past, please contact our office. Our office will be happy to arrange a phone meeting.
Ramesh P. Kanuru, MD
Last Updated 03/16/2008
Related
Links |
|
The American Academy of Pain ManagementEmployment Opportunities |
|
Monthly Articles |
|
©2003 copyright Advanced Pain Consultants. Reproduction or redistribution of content is expressly forbidden without the express written consent of Advanced Pain Consultants - 866-656-1100 |