Spinal cord stimulation has been successful in pain management of a subgroup of back pain patients that do not respond to
minimally invasive procedures such as epidural injections, and are not candidates for Spinal surgical interventions. This
modality has also been successfully used in patients with Failed Back Surgery Syndrome, Neuropathies/Neuralgias, Peripheral
Vascular Disease, Arachnoiditis, Phantom Limb Pain, and Complex Regional Pain Syndromes. After initial evaluation, if you are
deemed to be a good candidate, educational material in the form of a video tape and brochure will be given to you by your
physician. A psychological evaluation might be necessary prior to the procedure; in some situations the insurance companies
mandate this evaluation.
The procedure is performed in two stages. The first step is the trial and does not involve an incision. During this stage after an
IV and antibiotic infusion is started in the preop area, you will be placed in the prone (face down) position. The area of initial
injection will be numbed by local anesthetics and using live X-ray, the epidural space will be accessed by a needle. The leads
will then be advanced into the epidural space to the desired level using fluoroscopic guidance.
During the procedure, your physician will ask you question about the quality of stimulation and the coverage area. If the painful
areas are covered successfully, the leads will be tied to your back and connected to an external device the size of a remote
control. The patient will have the ability to control the extent of stimulation with this device. The patient will be sent home after
the procedure to try the device for a few days. If the trial is not successful, the leads will be taken out of your back easily in a
few minutes.
Only if the trial part is beneficial the second stage will be scheduled. This part will involve two small incisions in the back and
buttocks area, but all of the other steps are similar to the trial. This stage is also an outpatient procedure, and you will go home
after recovery from anesthesia. The sutures will be removed in the office within one week after the procedure.
