Neuromodulation Reversible Modulation of Nerve Transmission

Epidural Spinal Cord Stimulation (Electrical Stimulation of the Spinal Cord)

Epidural Spinal Cord Stimulation

An electrode is carefully placed in the epidural space near the spinal cord, similar to spinal catheter procedures. A temporary neuronal pacemaker is brought into place and activated. The patient then describes the quality and location of the stimulation. The physician must adjust the position of the electrode until an optimal stimulation of the affected area is achieved.

When the electrode is properly situated the patient should feel a tingling where he or she previously felt pain. The neuronal pacemaker is implanted underneath the skin after successful placement.

Indications

• neuropathy (nerve pain)
  
• radiculopathy (irritation of nerve roots)
  
• phantom pain
  
• pain syndromes such as failed back surgery syndrome (pain continuing even after back surgery)
  
• arterial occlusive disease
  
• polyneuropathy (multifocal nerve pain)
  

Value

A substantial reduction of pain is possible with the procedure. For many patients, especially those who have already undergone surgery, it is the only solution available to long-term drug therapy. Patients are often able to reduce their use of powerful pain medications and thus the side-effects that go along with them. Quality of life and mobility, often severely restricted by the use of pain medication, is greatly improved.

Advantage

This is a minimal invasive procedure, available on an out-patient basis. Medications can be reduced after treatment.

Follow-Up

Activity should be minimized immediately following the procedure. Sudden movements must be avoided until after the implant has been stabilized, which can take up to several weeks. Stimulation can change during the first week after the procedure, making reprogramming of the implant by the physician necessary. The patient can resume his or her activities after this initial period of adjustment.

Work

Physical activity is not possible for up to several weeks after the procedure. Light physical activity can be resumed after this initial period of stabilization.

Sport

The extent of physical activity is determined by the healing and stabilization processes. Light physical activity such as hiking, biking and swimming can eventually be resumed.

Results

The international literature reports a reduction in pain following successful treatment of 50% to 75%.

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