Spinal cord stimulators are pacemaker-like devices that can be placed in the space above the spinal cord to deliver low intensity electrical pulses to the spinal cord. This is similar to the process used by cardiac pacemakers to deliver pulses to the heart. The spinal cord stimulators are an alternative method of pain management for patients who have not responded to medications and other alternative approaches. They provide an alternative to nerve blocking, cutting, cauterizing or other destructive measures for treating chronic pain. By delivering a small current over the back of the spinal cord sac, the signal is thought to override pain signals and replace them with a more pleasant tingling-like sensation in the area of the pain. However, the precise mechanism is probably more complex than that. Some theories about mechanisms suggest that the stimulation may release chemicals in the spinal cord and brain which then inhibit pain signals. Otherwise, it may release chemicals, such as endorphins (the brain’s natural pain reliever chemical), that have a pleasant effect.
Regardless of the mechanism, research studies are showing spinal cord stimulators have a reasonable success rate (defined as at least 50% reduction of pain) in treatment of some cases of chronic back pain, chronic neck pain and pain related to nerve damage of the arms and legs. Positive results have been seen in failed back syndrome (postlaminectomy syndrome), complex regional pain syndrome(reflex sympathetic dystrophy) , post herpetic neuralgia, ischemic pain (pain due to poor blood flow) involving the limbs and heart, and peripheral neuropathic processes such as diabetic neuropathy. This area of pain management is continually evolving. Developing investigations include moving the focus of stimulation from the spinal cord to directly stimulate malfunctioning nerves peripherally.
Spinal cord stimulator is not appropriate in all chronic pain situations. However, reasonable success is being seen with proper patient selection, proper positioning of the device and proper device selection in concert with appropriate stimulation parameters.
Regardless of the mechanism, research studies are showing spinal cord stimulators have a reasonable success rate (defined as at least 50% reduction of pain) in treatment of some cases of chronic back pain, chronic neck pain and pain related to nerve damage of the arms and legs. Positive results have been seen in failed back syndrome (postlaminectomy syndrome), complex regional pain syndrome(reflex sympathetic dystrophy) , post herpetic neuralgia, ischemic pain (pain due to poor blood flow) involving the limbs and heart, and peripheral neuropathic processes such as diabetic neuropathy. This area of pain management is continually evolving. Developing investigations include moving the focus of stimulation from the spinal cord to directly stimulate malfunctioning nerves peripherally.
Spinal cord stimulator is not appropriate in all chronic pain situations. However, reasonable success is being seen with proper patient selection, proper positioning of the device and proper device selection in concert with appropriate stimulation parameters.
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