Spinal Cord Stimulation
What Is Spinal Cord Stimulation?
Spinal cord stimulation is a reversible, safe, and functional means of managing specific types of chronic pain that has not responded to other treatment modalities, such as steroid injections, or physical therapy.
Chronic pain is a condition experienced by more people in the United States than diabetes, heart disease, and cancer combined, according to the National Institutes of Health. Cited as the most common reason that people contact their healthcare provider, pain is the leading cause of disability and chronic pain is the leading cause of long-term disability.
Estimates of the prevalence of chronic pain disorders in the United States have been as great as 30%. The Institute of Medicine estimates that nearly 116 million United States citizens suffer from one type of chronic pain condition.
This is only slightly lower than the 19% of people in 15 European countries who reported suffering from pain for greater than six months.
Spinal Cord Stimulation History
Much technological advancement has been made since the development of the stimulator in the early 1970s that improved the effectiveness of the procedure in relieving and reducing neuropathic pain. In the original procedure to place the spinal cord stimulators, electrodes were positioned in the subarachnoid space.
This is the space between the arachnoid and pia mater membranes that protect the brain, also known as the meninges. Changes were made in the 1970s when new electrode placement made it feasible to be located in the epidural space, outside the protective membranes that surround the spinal cord. The changes reduced the risks with spinal cord stimulation, such as leakage of the cerebrospinal fluid, infection, or inflammation of the meninges.
Today there are two different kinds of electrodes for stimulation devices: surgical and transcutaneous. The procedure is regarded as effective, reversible, and a safe treatment option for chronic pain as a result of neuropathic disturbances.
Previously, studies have examined the effectiveness and found that above 70% of patients who used spinal cord stimulation for their chronic neuropathic pain reported continued benefits from the device after a one-year follow-up. Scientists estimate that approximately 14,000 of these stimulation devices are used every year for the treatment of chronic pain worldwide.
Spinal Cord Stimulation – Conditions
Patients can expect to undergo a complete assessment of the types of pain and treatment attempted prior to prescribing the use of a spinal cord stimulator. While there are a number of different conditions that can be expected to achieve good results with the stimulator, the assessment is necessary to rule out the potential for other more conservative treatments.
The assessments will include a history of the symptoms, treatments that have been tried and the results from those treatments, family history, and other applicable information the physician gathers to make appropriate recommendations.
Physicians may use questionnaires to fully evaluate the pain condition, while clinical judgment is used for diagnosis.
It is vital that the patient report symptoms accurately and report other symptoms or medical conditions. The information is used to determine the best treatment modality for the patient and to determine the exact placement of the electrodes during the procedure if the physician recommends a spinal cord stimulation device.