24 Oct Advanced Chronic Back Pain Treatment
Chronic back pain treatment measures include the use of a spinal stimulator. Now, spinal stimulators are used in patients who have chronic back pain that doesn’t respond to conservative and invasive procedures. These include oral medications such as anti-inflammatories, anti-epileptic and narcotic medications, physical therapy, and injecting affected areas with local anesthetic agents and/or steroidal drugs.
How do spinal stimulators work?
In order to understand how a spinal stimulator implant works, one has to understand how chronic lower back pain develops. Injury or trauma to the peripheral or central nervous system causes a sharp, stabbing and intense burning pain to the affected area. This is referred to as neuropathic pain.
Spinal cord stimulators work by producing an electrical current that interferes with the transmission of pain signals from the affected area to the brain. These pain signals are substituted for a more pleasant sensation by these devices.
Conditions managed by spinal cord stimulators
As mentioned, spinal cord stimulators are used to manage chronic back pain where conventional therapies have failed. These conditions include diabetic neuropathy, complex regional pain syndrome, reflex sympathetic dystrophy, and a post-laminectomy syndrome which occurs after failed back surgeries were performed to manage nerve-related pathologies.
Spinal cord stimulator trial
Before a permanent spinal cord stimulator can be placed, a potential recipient of the device needs to undergo a spinal stimulator implant trial. This process involves partial implantation of the spinal stimulator’s wires and electrical leads into the patient’s epidural space, along with their spinal cord. These wires are then attached to a portable generator which is worn outside of the body, usually attached to the belt or placed into a type of pack worn on the back.
The spinal cord stimulation trial is then performed for five to 10 days in order to determine if the device offers the patient pain relief from their pathology.
Implanting the permanent device
If the spinal cord stimulation trial is successful, the patient and their doctor will make the final decision to proceed with the surgery for placement of the permanent spinal stimulator implant.
The procedure is performed by heavily sedating the patient if they cannot tolerate a general anesthetic. A small incision will then be made in the lower abdomen or buttock of the patient and the permanent implant will be placed between the fatty layer and muscle tissue. The wires of the permanent implant will then be connected to the leads that were placed during the trial period (since they are already positioned by the spinal cord). The incision will then be closed with suture material and the patient will be transferred to the recovery room.
There, nursing personnel will monitor the patient for 30 to 45 minutes until they are orientated and their vital functions are adequate enough to be transferred to the ward for further routine post-operative monitoring.
How effective is the spinal stimulator implant?
Clinical studies have demonstrated that spinal cord stimulator implant procedures have been successfully performed in 90 percent of patients who received them, and offered up to 70 percent pain reduction in most of these patients.