About Spinal Cord Stimulators
A spinal cord stimulator is a small device implanted in your body that provides gentle, pain-relieving electrical stimulation to the spinal cord. It is used to treat back, neck, leg and/or arm pain that has persisted, despite a spine operation. Spinal cord stimulation can be phrased a number of ways. If you’ve discussed this treatment option with your doctor or surgeon, you may have heard of it referenced as “spinal cord stimulation”, “spinal nerve root stimulation”, “dorsal root ganglion stimulation” (AKA “DRG stimulation”) or “peripheral nerve stimulation”.
Patients who seek out spinal cord stimulators often have persistent pain after spinal surgery are usually diagnosed with failed back surgery syndrome (FBSS) or post-laminectomy syndrome – these are estimated to affect around 40 percent of patients who undergo spine surgery. Many of these patients elect to undergo spinal cord stimulation to treat this pain, as studies have shown that spinal cord stimulation is safe and effective at reducing pain in a majority of these cases.
Treatment Goals for Spinal Cord Stimulation
The goal in spinal cord stimulation treatment is to help you feel more comfortable. It does not resolve the cause of spinal pain, but rather it interrupts the spine’s pain signals to the brain. Most patients who undergo spinal cord stimulation are able to better manage their symptoms, as well as reduce or even stop taking their pain medication.
The first step in spinal pain stimulator treatment is the placement of temporary electrodes in the epidural space of the spinal canal to see if the therapy is helpful. This is called the “trial”. For the trial procedure, after you are given light sedation and a local anesthetic, your surgeon will insert the electrodes into your back and guide them along your spine using an X-ray.
Once the electrodes are in place, you may then be asked to provide feedback to your surgeon to determine the optimal electrode placement, depending on the type of leads that are used. In this situation, the goal is to overlap the stimulation sensations with the painful area as much as possible.
After the procedure, the patient usually goes home the same day. The electrodes usually stay in place for 1 week, after which they are removed in the office.
If the patient does well with the trial electrodes, then the patient may schedule permanent implantation of a new stimulator system. The electrodes are placed in a similar fashion as during the trial. These electrodes are then connected to an implantable pulse generator (IPG), similar to a pacemaker battery. The battery is usually placed along the low back or the buttock through a small incision. Once the equipment is properly placed, the incision will be closed and you will begin your recovery.
Recovery for Spinal Stimulator Surgery
Most patients are discharged either the day of the surgery or the day after. You will be advised to rest during the first two to three weeks after your spinal pain stimulator operation. You may find this initial period slightly painful, as with most surgeries, and you will be prescribed medication to manage your pain. After two to three weeks have passed, you may be allowed to return to light activity. Your surgeon will give you instructions as to activities you should avoid and precautions you should take.
A complete recovery usually takes six to eight weeks. During this time, your doctor may prescribe physical therapy. Not only does exercise aid in the recovery process, but it can strengthen your back muscles and prevent future issues when incorporated into your everyday regimen.