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Spinal Cord Stimulation / Neuromodulation


 

The physicians of Innovative Pain Specialists may recommend spinal cord stimulation for your chronic pain. This treatment can be very effective and is indicated for chronic pain. It has shown to be of benefit in those with neck pain, arm pain, chest pain, abdominal pain, low back pain, leg pain as well as pain due to neuropathy. There are several instances where this treatment can be effective, and we encourage you to discuss this with your physician. This is an interventional technique that is used in order to minimize the need for systemic medications, opioids, and/or invasive surgery.

Spinal Cord Stimulation (SCS) can be a very effective procedure for many patients. It is only performed in those with chronic pain and is offered only for select patients. At Innovative Pain Specialists, we will use all available clinical information in order to determine if you are a candidate for this procedure. It is usually not an initial treatment recommendation, but rather, it is often performed after conservative options have failed. This is a procedure that is designed for long-term pain control.

It involves a two step process:

First, the patient undergoes a trial period. This is an excellent characteristic of this treatment. In essence, you will be provided with a temporary unit in order to try this device out at home, for up to one week. You will use this trial period in order to determine if it helps your pain, improves your quality of life and if you can be more functional. First the patient is brought to the procedural suite and provided with light sedation. This is usually performed in the office. You are provided with local anesthesia, and small wires or "leads" are placed through a needline and into the epidural space under x-ray guidance. This "lead" is a medical-grade wire with electrodes on the end of it, for the purpose of transmitting an electrical field near the nerve. These leads are about the diameter of the tip of a pencil. Once the lead(s) are in place, then a sterile dressing with adhesive tape is applied to the back. There are no incisions for this procedure, and you will be sent home with just a sterile adhesive dressing on your back. During the one week trial period, you will be in full control. You will have the ability to turn the device on or off, and you will have the ability to use different programs. A device representative will contact you every day during the one week trial period to gauge your progress with the device and to provide you with guidance on using your device. We ask that you use this one week trial period in order to determine if this alleviates your pain and/or improves your ability to function. At the completion of the one week trial, you will return to the office and the wires will be painlessly removed. This takes just a few seconds and is painless, and most importantly, it does not require any additional procedures. Once the leads are removed, you will be asked a series of questions to determine if this device is right for you on a long-term basis. If it is not right for you, then no additional procedures will be performed. If you do get significant relief, then you will be scheduled for the second step in the process.

The second step is implantation of the device. If you have a successful one week trial, then you will be scheduled to have the device implanted underneath the skin in order to provide you with long-term pain relief. This part of the process is considered a minimally invasive surgery and is usually performed as a same day surgery. The device is made up of a "battery" (known as the IPG, which also generates the electrical pulse) which is implanted under the skin of the low back or buttocks, as well as the leads which are implanted into the epidural space. As stated above, the patient will go home the same day and no hospitalization is required. You will be provided with a wireless handheld programmer (the size of your cellphone or smaller) in order to turn the device on or off. In addition, you will be able to change many different settings using the handheld programmer in order to manage your chronic pain.

Types of Neuromodulation offered:

1. Traditional (or "Tonic") Dorsal Column Spinal Cord Stimulation

2. Sub-perception (or "no-feel") Dorsal Column Spinal Cord Stimulation

3. Burst Dorsal Column Spinal Cord Stimulation

4. High-Frequency Spinal Cord Stimulation (10,000Hz)

5. Dorsal Root Ganglion (DRG) Stimulation

6. Peripheral Nerve Stimulation

*We work with several different Spinal Cord Stimulation companies: Boston Scientific, Abbott, Medtronic, Nevro, StimWave, etc.

>For more information regarding spinal cord stimulation, click here.

>For an animated video of the procedure, click here.

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