Spinal Cord Stimulation

Posted by steeldove @steeldove, Oct 25, 2018

Spinal Cord Stimulation – A Compelling Treatment Alternative for Chronic Pain
Vladimir N. Kramskiy, MD
Assistant Attending Neurologist, Hospital for Special Surgery
Clinical Assistant Professor of Anesthesiology, Weill Cornell Medical College

What Is Spinal Cord Stimulation?

Spinal cord stimulation is a neuromodulation technique that is used to treat various types of chronic pain. Neuromodulation is a pain management therapy that uses electrical signals delivered by an implanted device to alter nerve activity in specific parts of the body in order to reduce pain. Similar to the way a pacemaker corrects an abnormal heartbeat, a neuromodulation device can establish neurological balance that may help reduce symptoms associated with pain.

The field of neuromodulation has developed rapidly since the first implantable spinal cord stimulator device was used to treat pain in 1967. A specialized pain management doctor can implant the transmitter device through a minimally invasive surgery. Physicians who have specific training in neuromodulation techniques have reduced complications and adverse events associated with this procedure. For this reason, it is vital that patients carefully choose a board certified pain specialist with expertise in neuromodulation before committing to any therapy.

Newer spinal cord stimulation devices and technologies have resulted in improved outcomes. The treatment involves placing electrodes next to a specific spinal area presumed to be the source of pain. These, in turn, provide an electric current which achieves the neuromodulatory effects that relieve pain.

Any patient who is considered a good candidate for spinal cord stimulation therapy must go through a thorough screening process before undergoing the procedure. This includes:

In-depth history and physical examination to assess for medical conditions that increase the risk that the treatment will either fail or create complications
Routine laboratory evaluation (determined based on the patient’s medical history and the type of anesthesia that will be used during the implantation procedure)
Relevant spine imaging studies (for example, X-ray films, CT and MRI scans) to assess the potential for technical difficulties that could arise during the procedure and to identify those patients for whom surgery may be a more appropriate treatment
Psychological screening (often required by insurance companies for approval of payment)
For patients with cardiac issues, a consultation with a cardiologist as well as a compatibility test
Despite this careful selection process, some patients will not achieve optimal pain relief with spinal cord stimulation. Most often, this is due to factors such as lifestyle (for example, preexisting tobacco or drug use), age or a lengthy delay between the first appearance of pain symptoms and device implantation.

What Patients Need to Know About the Spinal Cord Stimulation Process

First, a patient who is a good candidate for neuromodulation therapy is given a trial of the treatment. This trial tests the effectiveness of pain control and the patient’s tolerability to the device before it is permanently implanted.

During the trial period, which typically lasts three to seven days, temporary leads are placed via needle and connected by an extension cable to an external generator. A trial is considered successful when it results in pain relief of at least 50% accompanied by an improvement in function.

After the trial period, the leads are removed and the permanent implantation is performed at a later date (typically, two to four weeks later, to make sure there is no evidence of infection). A small incision is made during the implantation surgery. About a week after the implantation, a patient will return the office so that the healthcare team can monitor the healing process and review the settings of the device. Initially, most spinal cord stimulators need slight adjustments in the first few weeks after implantation, but the settings are often stable thereafter.

Spinal cord stimulation is a compelling treatment alternative for patients with chronic pain who have failed conservative treatment approaches. While it may not be effective for all types of pain or for every patient, spinal cord stimulation is a safe, drug-free and cost-effective treatment for many chronic pain conditions.

Posted: 10/8/2018

@kimspr3

I had the stimulator and I did find relief. There are a few types they offer meaning the kind of stimulation that feels good. I chose a constant vibration. After the implant patient is assigned to a Rep. from the Company, they will offer you different setting.

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I had the same experience but with one leg, had pain leg also. That was a few years ago so I don't remember if it went to the waist. At that time it did not wk. for the spine, maybe it's different now. Before the implant you have to go through a trial ,Insurance requires, than you will know if it's right for you or not.

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Thank you for your repely. I'm in a lot of nerve pain on my left side from the waist up and down my arm, bad headaches, and neck pain
I'm told Chiari,but I don't feel right about it! My gut says pinched nerve! Looking for answers,to be pain free,sick of hurting! I'll pray for you, and thanks

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Welcome @sandramm9, I believe you wanted to post a message that you, too, have similar symptoms. To post a message, click REPLY (not the Report flag).

Are you considering spinal cord stimulation?

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I have a question to put out there. I had spinal fusion surgery, L4 -S1 in Oct. 2019. I have not had any relief of pain and in fact there have been a number of incidents that I had what is called a flair up where the pain was extreme. My surgeon has suggested a spinal cord simulator. Has anyone had one of these implanted after having spinal fusion surgery and if so how long after the surgery was it done.

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I had the same L4,L5,S1 fusion 25 years ago..the 2 plates and 6 screws are still in there. They took bone from my hip to pack around the fusion. I have had no …. absolutely no problems since..the fusion was kept very stable.. great surgeon team in Oklahoma City.. k

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How do I go about finding out if my pain doctor is a board certified pain specialist with expertise in neuromodulation. My doctor is Dr. Goentzle with Ascention Via Christi in Wichita, Kansas.

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Go to or call the KU medical center/ hospital in Kansas City . ..It is closer to go to the OU Medical Center in OKLAHOMA City. My spine surgeon was James Odor ..he may be retired…but I have had really good results that did not need a stimulator..they don't solve the problem.. just screen it …

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@camil1957

How do I go about finding out if my pain doctor is a board certified pain specialist with expertise in neuromodulation. My doctor is Dr. Goentzle with Ascention Via Christi in Wichita, Kansas.

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@camil1957

If your doctor has a website, you could perhaps find the answers to your questions. I look up reviews at vitals.com and Googlescholars.com and LifeScripts.com. I like to see what patients have thought about a doctor.

Jim

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@camil1957

How do I go about finding out if my pain doctor is a board certified pain specialist with expertise in neuromodulation. My doctor is Dr. Goentzle with Ascention Via Christi in Wichita, Kansas.

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@camil1957 I looked up Dr. Brian Goentzel on vitals.com and found that people loved him while others were deeply offended by his demeanor and rudeness. He's first an anesthesiologist, and more recently a pain specialist.

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@ceceilia

I have a question to put out there. I had spinal fusion surgery, L4 -S1 in Oct. 2019. I have not had any relief of pain and in fact there have been a number of incidents that I had what is called a flair up where the pain was extreme. My surgeon has suggested a spinal cord simulator. Has anyone had one of these implanted after having spinal fusion surgery and if so how long after the surgery was it done.

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Had surgery year ago. No help. Had stimulator put in back yesterday! Seems to really be working good!

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@wilcy

Had surgery year ago. No help. Had stimulator put in back yesterday! Seems to really be working good!

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Did you do the 7 day trial? I hope it helps you for a long time.

Jim

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@ken82

I had the same L4,L5,S1 fusion 25 years ago..the 2 plates and 6 screws are still in there. They took bone from my hip to pack around the fusion. I have had no …. absolutely no problems since..the fusion was kept very stable.. great surgeon team in Oklahoma City.. k

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Last year had mine done in ok,city

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@wilcy

Last year had mine done in ok,city

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I remember my trial. It was wonderful to feel nearly pain free! I had forgotten how that felt. But then I had to wait for a couple of months to be scheduled for the implant. With my stimulator, I had to wait for 6 weeks, giving the surgery site time to heal. The scar tissue would have been in the way of the nerves sending their signals. But after those 6 weeks, I felt 80% pain relief. It's hard to describe to someone who hasn't experienced chronic, intractable pain. Enjoy!

Jim

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@ceceilia

I have a question to put out there. I had spinal fusion surgery, L4 -S1 in Oct. 2019. I have not had any relief of pain and in fact there have been a number of incidents that I had what is called a flair up where the pain was extreme. My surgeon has suggested a spinal cord simulator. Has anyone had one of these implanted after having spinal fusion surgery and if so how long after the surgery was it done.

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I had the Stimwave spinal stimulator implanted July 2019 after fusion in 2014 failed . Had a successful trial then permanent place and has been a nightmare ever since. One lead migrated and had to have it replaced. Having to travel 100 miles for program changes due to it over stimulating other areas of my back and causing even more pain than my original pain . Your dealing with Sales Reps not clinicians. There first priority is to sell not help the patient . I wouldn’t recommend the Stimwave device . Research everything and everyone . It’s been pure hell

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@jimhd

I remember my trial. It was wonderful to feel nearly pain free! I had forgotten how that felt. But then I had to wait for a couple of months to be scheduled for the implant. With my stimulator, I had to wait for 6 weeks, giving the surgery site time to heal. The scar tissue would have been in the way of the nerves sending their signals. But after those 6 weeks, I felt 80% pain relief. It's hard to describe to someone who hasn't experienced chronic, intractable pain. Enjoy!

Jim

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Thank you for your input. It helps to know that there is hope for me to be pain free or almost pain free.

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