Managing Chronic Pain with Spinal Cord Stimulators
Despite various conservative and surgical efforts to alleviate pain, some individuals continue to suffer from chronic discomfort. For such cases, a spinal cord stimulator can be a viable solution. This device, permanently implanted in the spinal canal, aims to transform painful sensations into more tolerable tingling sensations, improving the patient’s quality of life.
How Spinal Cord Stimulation Works
A spinal cord stimulator doesn’t alter the underlying condition but changes the brain’s perception of pain. Small leads with multiple electrodes are placed over the spinal cord, converting pain into a less distressing sensation.
Two-Phase Surgery
The procedure involves two stages. Initially, the leads are placed and connected to an external power supply for a trial period, typically lasting several days to weeks, to assess pain control effectiveness. If successful, a permanent system is implanted. If the trial fails, another attempt may be made before the leads are removed permanently.
Conditions Treated
Spinal cord stimulators can address various chronic pain conditions, including:
- Failed back surgery syndrome
- Multi-level degenerative problems
- Disorders affecting pain signal processing
Pre-Surgery Preparation
Once you decide to proceed with the surgery, the following steps will occur:
- Medical examination
- Chest X-ray, EKG, and blood work
- Possible neurological or psychological examination
Before the procedure, you should:
- Discontinue aspirin or anti-inflammatory medications at least one week prior
- Follow specific instructions for any other medications, including herbal supplements
- Refrain from eating or drinking for 6 to 8 hours before the surgery
During the Procedure
The procedure involves the following steps:
- Administration of a mild sedative while remaining awake
- Application of a local anesthetic to the operative area
- Insertion of needle and leads into the spinal cord using fluoroscopy for guidance
- Activation of the device to ensure proper placement of leads
- Connection of leads to an external generator for testing
Post-Procedure Care
After the surgery, you will:
- Spend 1 to 1½ hours in the recovery room
- Receive post-operative care instructions from the surgeon
- Be provided with a device to control the stimulator
- Avoid twisting and bending to ensure proper healing
If the trial is successful, a permanent system will be implanted. While spinal cord stimulators may not eliminate all pain, they aim to significantly reduce it, enhancing your quality of life.
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Frequently Asked Questions
Does spinal cord stimulation remove all pain?
Most patients experience significant pain reduction, though some minor discomfort may persist.
Will I still need to take pain medication?
The need for pain medication typically decreases, though some patients may still require it.
Can I control the stimulation therapy?
Yes, you can turn the device off and on and adjust the stimulation levels as prescribed by your specialist.
Will I be able to see and feel the spinal stimulator device?
The stimulator is small and discreetly placed, but it may be detectable with effort.
Does insurance cover the procedure in NY?
Most insurance plans, including Medicare, cover the procedure, often requiring a psychological evaluation to ensure patient readiness.
Why is a psychological evaluation necessary?
This evaluation helps address potential anxiety or stress related to having a foreign device implanted and ensures the patient understands the procedure’s expectations.
What is the recovery time?
Recovery typically takes 1-2 weeks, during which heavy lifting and intense activity should be avoided.
Meet Dr. Tanuj Palvia, MD – Board Certified in Pain Management and Anesthesiology
Dr. Tanuj Palvia, MD
Board Certified in Pain Management and Anesthesiology