Spinal cord stimulation (SCS) is the use of low voltage stimulation of the spinal nerves to interfere with pain perception. A spinal cord stimulator is an option for the treatment of chronic pain, and SCS decreases the need for pain medicine. An intrathecal pain pump is used to deliver pain medication directly to the spinal cord. This small pump is surgically placed in the lower abdomen, and a catheter runs from the unit to the spinal cord. The pain pump is used for people who fail to have relief of long-term pain.
How does a spinal cord stimulator work?
A spinal cord stimulator involves low voltage stimulation of spinal nerves, which interferes with feelings of pain. The use of SCS is known to decrease the patient’s pain medication requirements. A small, battery-operated device is implanted in the lower abdomen or buttock region. Wires run from the unit and attach to electrodes, which are surgically placed along the spinal cord. The unit sends electric current to the spinal cord, which results in a tingling sensation. This interrupts pain signal transmission, and gives the patient a pleasant sensation, rather than a painful one.
What is the purpose of spinal cord stimulation?
The stimulation does not eliminate the source of the pain. Rather, it interferes with the signals of pain to the brain. The amount of pain relief will vary from patient to patient. The goal of SCS is to offer around 70% reduction in pain. However, some patients feel than any pain relief is better than no pain relief. Because stimulation does not work for all people, a trial stimulation is performed before the unit is permanently implanted. If the device quits working for the patient, the implant can be removed without damaging the spinal cord or associated nerves.
Who is a candidate for spinal cord stimulation?
Before the pain management specialist performs a spinal cord stimulator implant procedure, he will thoroughly assess and evaluate the patient. This involves a history of pain management efforts, as well as inquiry into which treatments did or did not work. In addition, a psychologist will assess the patient’s condition to evaluate the probability of a successful outcome. Patients who are candidates for SCS include:
- Those who have had a disability for more than one year.
- People who have pain in the lower back and/or leg (sciatica).
- People who have had one or more failed back surgeries.
- Those who have failed on conservative therapies.
- People who experienced a successful trial stimulation.
- Anyone who is not dependent on pain medications.
- People who do not have psychiatric conditions that contribute to pain.
How does an intrathecal pain pump work?
The intrathecal pain pump is surgically placed in the patient’s body, and a small, thin catheter runs from the unit to the spinal cord. Medication is delivered directly to the spinal cord, so smaller doses are required. The pump’s reservoir holds the pain medications, which last for several months before being refilled. A nurse can refill the unit by inserting a needle through the patient’s skin.
What is the purpose of the intrathecal pain pump?
The goal of the intrathecal pain pump is to bypass side effects of oral medications while better controlling the patient’s symptoms. In addition, the potency of the medication used in the pump is around 200 times more than that taken orally. The pump stores information about the medication in the memory, so the doctor can review and make necessary changes. This therapy is reversible if the patient decides he or she wants the pump removed.
Who is a candidate for an intrathecal pain pump?
The intrathecal pain pump is not the best choice for every patient. However, some people will benefit from this treatment options. Before undergoing a permanent pump implantation surgery, the patient must undergo a trial to see if the device will decrease pain. Candidates for the intrathecal pain pump include:
- Anyone who is dependent on pain medication.
- People who have failed on conservative therapies.
- Anyone who will not benefit from additional surgery.
- People who do not have medical conditions that prevent the implant procedure.
People who are not allergic to pain medicines.