Spinal Cord Stimulation
We offer spinal cord stimulation to treat chronic pain syndromes such as post-surgical failed back syndrome and complex regional pain syndromes. We also use the procedure to treat peripheral neuropathy, which can be caused by blood flow limitations (ischemia) to the lower extremities or diabetes. We only use spinal cord stimulation on people who have failed standard medical treatments; spinal cord stimulation is not a frontline treatment because of its cost and invasive nature. Before we consider you a candidate for spinal cord stimulation, we will do psychological testing. Chronic pain is a multi-dimensional process. To treat pain fully, we need to help you with the cognitive and emotional aspects of chronic pain. This assessment helps to serve this purpose and underscores the transdisciplinary aspect of our Center.
Spinal cord stimulation is an outpatient procedure. First, we implant a temporary electrode in the epidural space over your spinal cord to see your response. If it works well, we use a permanent spinal cord stimulator. This device emits mild electrical pulses that stimulate the spinal cord directly. We program the device so that the amplitude, pulse width, and frequency best control your pain.
“These pulses intercept and modulate the electrical activity of the pain processing centers of the spinal cord,” says Dr. Brian Kopell, Director of the Center for Neuromodulation. “The idea is to alter the signals currently being sent to the brain that give rise to the pain phenomenon,” says Dr. Kopell.
The permanent spinal cord stimulator operates on batteries that last for about 10 years. At the 10-year mark, says Dr. Kopell, about half of patients report good results. You will work with your neurologist to determine the parameters of the electrical pulses—amplitude, pulse width, and frequency—that work best to control your pain.