Spinal Cord Stimulation has become a more recently used technique to treat chronic pain. In the Cincinnati area, we see it most often employed for failed back surgery syndrome. The proposed mechanism is by modulation of chemical neurotransmitters and at the level of the spinal cord to interfere with pain transmission from the painful area to the brain. A subcutaneously buried pulse generator is connected to electrodes placed in the epidural space over the spinal cord and the location, frequency, and intensity of electrical stimulation to the spine is adjusted to provide a pulse sensation that interferes with pain transmission to the spinal cord from the affected area. In effect, this substitutes one sensation for another. The medical literature notes better results with neuropathic pain than musculoskeletal pain or joint pain. Significant acute and long-term complications can occur and it contraindicates future MRI investigation of recurrent or new problems.
Modest decreases in opioid use, approximately 20-30% have been reported, and, while statistically significant reductions in disability and depression scales have been reported, the results have not been dramatic and only minimal return to work rates have been reported.
In recent years our clinic has had more stimulators removed than put in, either because of electrical lead migration, pain locally from the battery pack, or, dissatisfaction with the long-term result. The technique was first introduced in 1967 as a salvage procedure for refractory debilitating pain, but since the early 2000’s, it has become more widespread in community settings. We feel that routine use of this technique cannot be justified based on the literature and the experience of our patients who have had stimulators.
Interested in treatment for Spinal Pain from Carl M. Shapiro, D.O., Inc.?
Call our Cincinnati, OH office at (513) 791-5548 to learn more!