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27 May 2010
In this video, an Arizona Pain Specialist physician performs a minimally invasive procedure for chronic pain. Known as Spinal Cord Stimulation, this procedure is often referred to by experts as the "pacemaker for pain." This patient suffered from chronic pain due to a gunshot wound, where several pieces of shrapnel were still embedded in the patient's back, causing severe left leg pain and low back pain.
Referred to by some experts as a "pacemaker for pain," Spinal Cord Stimulation (SCS) is now a widely accepted treatment for pain management. Patients are generally treated conservatively prior to SCS, but should the physician find that all conservative treatment has failed, SCS is often an excellent option for chronic pain patients.
Debuted in the 1960’s and known then as dorsal column stimulation (DCS), the technology was researched in a patient group of 500 for a period of five years. The original implants didn’t show much success, due to technology issues, inexpert implanters, and poor patient selection among other factors. The last implant of the DCS was performed in 1973.
By the 1980’s, the technology had been improved upon and actually was similar to the technology used today. Percutaneous leads were developed, dual multipolar lead systems were utilized, and in 1999, Dr. Giancarlo Barolat replaced the name dorsal column stimulation with spinal cord stimulation.
Intended to manage chronic pain symptoms in the trunk area, limbs, or both, SCS can be used for a multitude of pain conditions and symptoms. Complex Regional Pain Syndrome (CRPS), sciatica, failed back surgery syndrome, low back pain and leg pain are common issues that are treated with SCS.
SCS works by sending small electrical impulses via thin, flexible lead wires to the site of pain. Rather than the perception of pain, the body will perceive a slight tingling or buzzing sensation known as “paresthesia.” Many patients report that the parathesia is a pleasant feeling, and is certainly far more desirable than the pain they had previously felt.
To be eligible for SCS, the patient must go through a standard process. Failure of conservative methods is generally the first criteria. Conservative methods may include but are not limited to medication management, hot/cold therapy, acupuncture, chiropractic treatment, biofeedback and minimally invasive procedures such as injections.
Once these measures have been exhausted, a patient may be considered eligible for SCS. A psychiatric and psychological assessment is required by insurance companies and occurs to ensure the patient is mentally capable of using the device. Quality of the pain is assessed (is it continuous, sharp, burning, aching, etc.) by the physician to discriminate whether the technology of the SCS would be helpful in the alleviation of the specific patient’s pain.
A trial device is usually placed and the trial takes place over several days. During this trial period, the patient is able to determine whether or not the SCS provides adequate pain relief for their particular condition. If the trial is deemed successful by both the patient and the physician, the permanent device may be considered.
The permanent device consists of thin, flexible lead wires that are attached to a small battery pack. The battery pack is placed in a small, subcutaneous (under the skin) pocket, unnoticeable except for an extremely small scar. The battery pack is small in size – a bit bigger than a book of matches, but smaller than a deck of cards. Once implanted, the settings
Side effects are minimal, and consist of minor pain post surgery at the surgical site, infections and lead migration.
The content on this website is for educational purposes only, and is in no way intended to replace your physician's advice. Please always consult your doctor before taking any advice learned here or on any other website.
