As a patient who is experiencing chronic pain, it may seem at times like are no options and depression may set in. A spinal cord stimulator may be an excellent option for getting patients in chronic pain back to living a fuller life.
As a patient who is deemed to be a candidate for spinal cord stimulator, here are the steps involved with getting one placed. The first step is to have a consultation with your doctor about exactly what it is possible to control with regards to your pain issues. It doesn't fix everything. In fact it actually fixes nothing. A spinal cord stimulator simply masks the perception of pain by altering the way the brain perceives it and replaces it with a tingling sensation. If you have a pain problem that does not have a surgical solution, a spinal cord stimulator may be perfect.
The next up is to have a trial implant put into place. This is performed as an outpatient under sedation anesthesia. The pain management doctor does not actually give patients general anesthesia for this procedure, because patient input is actually necessary. Through a tiny incision, the catheter is placed into the spinal canal and manipulated so that it is in a nice position typically over the center of the spinal cord. The patient is then asked if pain relief is achieved and where the tingling is felt. The catheter as it comes out of the skin is attached to a battery program unit and started up prior to asking the patient these questions. If the patient says the coverage is adequate then the position is fine. If the patient is not receiving coverage over the painful region the catheter is moved around until the patient says yes. There is a thin wire through the catheter so this can be done outside the skin by twisting it there.
At this point the catheter is left in place and a sterile dressing is applied, and in the recovery room the patient receives the battery unit that also doubles as a programming unit. For the next 5 to 7 days the patient wears the unit and sees what kind of pain relief he or she she feels.
Depending on the amount of pain relief felt the final implant is then discussed. Typically the number used by insurance companies and doctors is whether or not a minimum of 50% pain relief is achieved.
Assuming that 50% pain relief is achieved, the patient then undergoes a psychological evaluation to receive approval for the final implant. Most insurance companies require this prior to approval. Once this is accomplished, the final implant is then placed typically by a spine surgeon. It requires a larger incision and removing some bone from one of the areas over the spinal canal for placement of the larger paddle neurostimulation lead. These procedures typically take around 45 minutes to an hour and are also performed as an outpatient. There are two components to the final implant. One is the paddle lead placed into the spinal canal which is significantly larger than the trial lead. This allows quite a few programming options going forward. The paddle lead has an electrode wire that comes out of the spinal canal and into the soft tissues where it attaches to the second component, which is a neurostimulation battery pack. The battery pack is about the size of a hockey puck in shape and a little smaller in size. It is placed above the buttock region under the soft tissues of the skin or in the front in the soft tissues of the abdominal area off to the side.
Once the procedure is completed the unit is programmed over the next 24 hours and the patient is able to start reaping the benefits of it. The patient is taught how to program the unit and they wear a belt every few days to recharge the unit out from outside the skin.
A spinal cord stimulator for chronic pain can bring a new lease on life. They continue to improve technologically, and the current ones have an immense number of various programming options.
No comments:
Post a Comment