Spinal Cord Stimulator

What is a spinal cord stimulator?

A spinal stimulator is a device used for the treatment of chronic spinal pain, unresponsive to medical or surgical therapy. It works by sending low voltage electrical impulses to the spinal cord, blocking the sensation of pain from being transmitted from the spinal cord to the brain. A stimulator has to parts; a lead, or electrode, is a current transmitting wire placed on the surface of the spinal cord. The lead is connected to a neurostimulator, which supplies electrical impulses to the lead.

How is a spinal cord stimulator implantation performed?

To place a spinal cord stimulator, the surgeon places a needle through the skin and through a bony opening in the vertebrae. Through the needle a wire is placed and threaded into the epidural space of the spine, the space where spinal nerves travel. The wire is threaded to where it lies against the surface of the spinal cord. The wire lead is then connected to a battery, usually worn on a belt pouch. The procedure is performed under sedation and with local anesthetic.

What is a spinal cord stimulator trial?

At first, the lead is connected to a stimulator worn on a belt or pack. The stimulator is programmed to provide pain relief. The patient then goes home with the stimulator and wears it for several days to determine pain relief. If successful, the patient returns and the stimulator is implanted under the skin. The wire from the spine to the stimulator is tunneled under the skin and is not visible.

How long will the procedure take?

The procedure takes one to one and a half hours to perform. After the procedure you will recover for one to two hours before going home.

What is the recovery like?

You are encouraged to resume daily activities immediately after surgery and to maintain a careful pain log to assess success of a stimulator trial. If you are undergoing a stimulator trial you cannot shower or get the surgical site wet. After you have had your stimulator implanted you must keep the wound clean and dry for 5 days. Avoid strenuous physical activity for a week after the stimulator has been implanted.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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