This modality is usually offered to patients who have been tried on a variety of medical and minimally invasive treatments (e.g. epidurals) without significant success or when patients experience a lot of side effects with their current medical regimen. Patients who have significant neuropathic pain (nerve
generated pain) such as those with RSD (CRPS I & II), people with failed back surgeries, scar tissue around their nerves, and a lot of shooting pain in their legs are good candidates for this technique. The idea of spinal cord stimulation is to superimpose a pleasant sensation onto the painful areas.
In order to see if you are a good candidate for this procedure, it is done in two phases. The first phase is the trial phase. You will rest on your belly and under X-ray your doctor will place the lead in the epidural space. You will then be asked about the location of the sensation as your doctor finds the best location for lead and fine tunes the sensation in your painful areas. This can be done fairly quickly or may take a couple of hours depending on your pain pattern. Once the right location is found, your doctor secures the leads with tape onto your back. An extension cord will attach the lead to a hand held device that looks like a big pager. You will then be discharged with instructions on how to use the device. This test usually takes about 4-5 days, and during this time you will evaluate the effectiveness of this technique for management of your pain. This trial lead will then be pulled at an office visit. There will be no incisions for this phase.
If you have a good response during your trial phase, you will then be scheduled for your implantable device. During this phase, the lead is placed just like last time; however, once the location of it is determined, it is anchored underneath your skin in the back. An extension is then tunneled from your back to the top part of your buttock or your abdomen where the receiver or the battery of the system will be implanted. You will have sedation for thispart of the procedure. Depending on your pain pattern, your doctor will determine if you would be an appropriate candidate for an internal battery system or a non-battery system. The battery system requires change of the battery every two to three years based on the use. The non-battery system works through a wireless transmitter that you need to wear when you need to have the unit active, but there will be no need to change the receiver in the abdomen or the buttock area.