SPINAL CORD STIMULATION

Spinal cord stimulation (neuromodulation, neurostimulation or nerve stimulation) is a pain treatment that sends an electrical impulse to the spinal cord to block pain signals from traveling up to the brain.

We use this treatment for people that have moderate to high intensity persistent neuropathic pain and if more conservative strategies have been comprehensively trialled and failed.

In the treatment, we place electrodes to the spinal nerves and connect to a spinal cord stimulator (small battery operated device) that then sends tiny electrical pulses to nerves to mask pain. 

A temporary 1-2 week trial is first performed and if it restores nervous system function and sensation it provides an 70% chance of having greater than 50% reduction in pain. These are very good statistics when compared to pain medications alone, which only help less than 50% of people they are trialled on. 

UNDERSTAND SPINAL CORD STIMULATION IN 2 MINUTES

Spinal cord stimulation treatment is generally reserved for severe hard to manage neuropathic pain. Conditions typically treated by this pain treatment include:

• Postoperative persistent syndrome (POPS) (also called failed back surgery syndrome (FBSS), post laminectomy or spinal fusion pain)

• Complex regional pain syndrome (CRPS) (previously called reflex sympathetic dystrophy (RSD))

• Abdominal or visceral pain like angina (some cases only)

• Chronic peripheral ischaemic pain

• Pelvic pain

• Peripheral nerve damage

• Peripheral neuropathic pain

• Phantom limb pain

• Refractory angina pectoris

FORMS OF SPINAL CORD STIMULATION

Spinal cord stimulation that is used for pain relief includes:

• Spinal cord stimulation (SCS)

• Sacral nerve stimulation (SNS)

• Dorsal root ganglion (DRG) stimulation

• Occipital nerve stimulation (ONS)

• Peripheral nerve stimulation (PNS)

• Peripheral nerve field stimulation (PnFS)

DID YOU KNOW?

Neurostimulation is extensively used for pain control but it is also used in non-painful medical conditions like pacemakers, which restore abnormal heart rhythms, and cochlear implants, which restore hearing. Spinal cord stimulation was first used to control pain in 1967.

The technology has improved vastly over the years, to the point that they can now even be inserted with minimal discomfort.

Neurostimulation could be considered the game-changer in pain medicine because it has the ability to significantly reduce and sometimes completely eliminate chronic pain in some people. It does this by ‘closing the gate’ to pain signals that travel up the spinal cord. Neurostimulation when used for pain control, blocks the pain signals as they travel up the spinal cord.

1. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971-9. LINK

2. Song JJ, Popescu A, Bell RL. Present and potential use of spinal cord stimulation to control chronic pain. Pain Physician. 2014;17:235-46. LINK

3. Kumar K, Taylor RS, Jacques L et al. The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery. 2008;63:762-70 LINK

4. Al-Kaisy A, Van Buyten JP, Smet I, Palmisani S, Pang D, Smith T. Sustained effectiveness of 10 kHz high-frequency spinal cord stimulation for patients with chronic, low back pain: 24-month results of a prospective multicenter study. Pain Med. 2014;15:347-54. LINK

5. Bendersky D, Yampolsky C. Is spinal cord stimulation safe? A review of its complications. World Neurosurg. 2014 Dec;82(6):1359-68. LINK