Spinal Cord Stimulator

How Does It Work?

It is believed that applying electrical impulses to certain areas of the spinal cord can prevent pain signals from reaching the brain. The brain is almost “tricked” by feeling the stimulation signals, and ignoring the pain signals.

How Is It Done?

Under X-ray (fluoroscopic) guidance, a needle is directed into the epidural space, just below the end of the spinal cord. Electrical leads are passed into the epidural space to lie over the spinal cord. Electrical impulses are sent through the leads to stimulate the spinal cord and block pain signals. Using patient feedback, an optimal stimulation pattern is determined and programmed into the external stimulator. The patient is sent home and asked to resume normal activities. At the end of seven days, the leads are taken out. If patient had good pain relief, then the patient is scheduled with a surgeon to place the permanent stimulator. Permanent implantation is usually done under general anesthesia. The surgeon places the leads in the epidural space, and then connects the leads to the electrical pulse generator battery under the skin. The battery is usually placed over the buttock, or abdomen.

What Are The Risks?

As with any invasive procedure, there are some associated risks and complications. Anytime a needle is put into the body, there is a risk of infection, bleeding and allergic reaction. The risk of infection is prevented by using sterile techniques. The risk of bleeding is very minimal if patients are not on any blood thinners. There are very few allergic reactions to the medications that are used for the injection. If any allergic reactions are identified, medications will be given and patients will be observed to prevent any serious complications.

Epidural lead placement may also pose a risk for a spinal headache. A spinal headache is a headache that gets worse with sitting up. It usually improves in 1-2 days with lying flat, drinking water and taking caffeine. Occasionally, a persistent spinal headache must be treated with a blood patch. Patients with a persistent spinal headache should contact the office.

What Can I Expect After?

Patients usually go home about 20-30 minutes after the injection. Patients are educated on the use of the external spinal cord stimulator. Patients are advised to rest on the day of the injection, but may return to normal activities the next day. Patients will often be instructed to make a follow-up appointment in seven days after the trial implantation.