Spinal Cord Stimulator Q&A

Chronic pain is a serious public health problem, affecting more than 20 million U.S. adults. Lower back pain is the most common type of chronic pain; about 80 percent of people experience it at some point in their lives. For years, patients suffer debilitating neuropathic pain despite surgery and pain medications. An alternative and effective treatment to chronic neuropathic pain involves spinal cord stimulation. Spinal cord stimulation is a therapy which stimulates specific nerve pathways in the spine to interrupt the pain signals from reaching the brain. It’s a small device that is implanted in the body to deliver electrical pulses to these pathways within the spinal cord. It helps people manage their chronic pain symptoms and reduce or eliminate the use of opioid pain medications.

What is it?

Spinal cord stimulators are composed of thin wires and a small, pacemaker-like battery pack. The thin wires are placed between the spinal cord and the vertebrae, the epidural space, and the battery is placed under the skin, usually near the buttocks or abdomen. The waveform/electric parameters are all adjusted remotely through your own personal device to get the most reduction in pain.

Spinal cord stimulators require two procedures to test and implant the device – the trial followed by implantation if the trial is successful. Each patient is different but generally people who benefit from spinal cord stimulation are those who still have pain despite failing other conservative measures as well as spine surgery. The devices can be rechargeable or non-rechargeable depending on joint decision making between the patient and care team. Dr. Maheshwari and his medical team will explain the different types of spinal cord stimulators that best fits your medical needs.

How does it work?

Determining whether a spinal cord stimulator will work with a patient is a two step process involving the trial and then implantation. A spinal cord stimulator trial is the phase where Dr. Maheshwari will implant a temporary device for the patient to test out. It’s guided by X-ray, that allows the doctor to insert electrodes into the epidural space of the spine. For three to seven days, the patients evaluate how the device helps reduce the pain and if the pain reduction is greater than 50% along with a greater than 50% improvement in functions such as walking and sleeping, the patient moves to the next phase. If unsuccessful, the wires are easily removed without any impacts to the nerves or spine.

During the permanent implantation procedure, the wires are placed under the skin securely to minimize movement. This formal procedure can take 60-90 minutes and is performed as an outpatient procedure. Most patients leave after the anesthesia has worn off and the recovery is about 1 week.

What are the advantages?

Finding relief from chronic pain is complicated. The results of a spinal cord stimulator really depend on the thoughtful match with the patient and their need. Dr. Maheshwari takes tremendous care to select, trial, implant, educate and monitor his patients throughout the procedure. Clinical studies show good to excellent long-term relief in 80% of patients suffering from chronic pain. Spinal cord stimulators are reversible and if a patient decides at any time to discontinue, the wires and batteries can be removed in a brief same day procedure.