Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, ams and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

Spinal Cord Stimulation/Intrathecal Pain Pump

A neurostimulator is a surgically placed device about the size of a stopwatch. It delivers mild electrical signals to the epidural space near your spine through one or more thin wires, called leads. The electrical signals cause a tingling sensation in the area of your chronic pain.
Neurostimulation provides pain relief by blocking the pain messages before they reach the brain. The neurostimulator sends out mild electrical impulses that reach the brain faster than the pain signal can arrive. In other words, it outsmarts your pain. Instead of pain, you feel a tingling sensation. You can adjust the strength and location of stimulation using a handheld programmer. For example, you can regulate different levels of stimulation at different times of the day or for various activities – such as walking, sleeping, or sitting. If your neurostimulator features AdaptiveStim® technology, then it will automatically adjust stimulation when you are upright (sitting or standing), lying down, or active while in an upright position.

A complete neurostimulation system includes several components:

  • Neurostimulator – The device that generates the electrical impulses (usually placed under the skin in your abdomen or upper buttock)
  • Leads – Thin, insulated medical wires that deliver electrical pulses to the epidural space near the spine
  • Physician’s programmer – A computer at your doctor’s office that lets your doctor adjust the neurostimulation system and its settings
  • Patient’s programmer – A handheld device you can use at home to customize the stimulation (within the settings your doctor has selected)

The neurostimulation system does not make any noise. It may be felt as a small bump under your skin, but does not normally show through your clothes.

Neurostimulation provides advantages over other therapies for chronic pain:

  • Unlike other chronic pain treatments or surgeries, you can experience neurostimulation and see if it relieves your pain before committing to the long-term therapy
  • A screening test serves as a temporary evaluation period. The screening test is much like an injection, but instead of medication being placed into the epidural space, leads are positioned and connected to an external neurostimulator (battery pack)
  • It does not have to be a permanent procedure. The neurostimulator can be surgically removed if you do not like it or if you decide to pursue a different treatment
  • Unlike oral medications that circulate throughout your entire body, neurostimulation targets the precise area where you are feeling pain
  • A neurostimulator may provide relief when other treatments – like medications or injections – have not
Medtronic offers a variety of neurostimulation systems with different features tailored for different chronic pain symptoms. If you are a candidate for neurostimulation, your doctor can work with you to determine if Medtronic products, such as RestoreSensor®, RestoreUltra®, RestoreAdvanced®, or PrimeAdvanced®, are possible pain treatment options for you. RestoreSensor is the world’s first neurostimulator to automatically adjust stimulation when you change your position.
Unlike medications that circulate throughout your body in your bloodstream, drug delivery therapy releases medication directly into the fluid surrounding your spinal cord which may lead to fewer or more tolerable drug side effects.
The system consists of a pump and catheter, both of which are surgically placed under the skin. The pump is a round device that stores and delivers pain medication. It is placed in your abdomen. The catheter (a thin, flexible tube) is inserted into your spine and connected to the pump. During the surgery, your doctor fills the pump with pain medication using a needle. The pump sends the medication through the catheter to the spinal area where pain receptors are located. You return to your doctor’s office for more medicine when the pump needs to be filled.
The pump releases prescribed amounts of pain medication through the catheter directly to the fluid around the spinal cord, in an area called the intrathecal space. The pain medication approved for use in the pump include morphine sulphate and ziconotide. Many people experience significant improvements in their pain symptoms and quality of life after receiving Medtronic drug delivery therapy. However, realistic expectations are essential to satisfaction with any pain treatment. Drug delivery therapy cannot eliminate the source of your pain or cure any underlying disease, but it may help you to better manage your pain.

Drug delivery therapy offers advantages over other therapies for severe chronic pain:

  • A screening test serves as a temporary evaluation period so you can see if drug delivery therapy relieves your pain before committing to long-term therapy
  • It does not have to be a permanent procedure like back surgery. The system can be turned off or surgically removed if you do not like it or of you decide to pursue a different treatment
  • Unlike oral medications, drug delivery therapy releases medication directly into the fluid surrounding your spinal cord rather than traveling throughout your body in your bloodstream. This may lead to fewer side effects, such as nausea and constipation
  • Drug delivery therapy may provide relief when other treatments – like medications or injections – have not
The implanted pump and catheter are surgically placed under the skin. Surgical complications are possible and include infection, spinal fluid leak, and headache. You should not undergo the implant procedure if you have an active infection at the time scheduled for implant. Once the infusion system is implanted, device complications may occur which may require surgery to resolve. Drug overdose or underdose can result because of these complications and have serious and even life-threatening adverse effects. Possible complications include the catheter or pump moving within the body or wearing through the skin. The catheter could leak, tear, kink, or become disconnected. The pump could stop because the battery has run out or because of failure of another part of the infusion system. Additionally, inflammatory masses have been reported at the tip of the catheter that may lead to complications, including paralysis. Please discuss the benefits and risks of this therapy with your doctor.

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