Neuromodulation: A Brief Overview

Neuromodulation: Spinal Cord Stimulator technology adding quality to lives of people suffering from chronic pain

Introduction

The spinal cord stimulator (SCS) is a breakthrough technology that is currently bridging a gap between biomedical engineering and pain medicine. The spinal cord stimulator is a small device that is surgically connected to the nerve with a wire. A battery is usually implanted into the upper area of the buttocks, and the patient can dictate the frequency of the electrode with a remote control.

Functionality of the SCS

Nerve stimulation is done in two steps: 1) A temporary electrode is inserted beneath the to give the treatment a trial run. The electrode is connected to a stimulator that the patient can control. If the trial is successful, your doctor can implant a permanent stimulator under your skin. This is typically done under local anesthesia. 2) The stimulator is implanted under the skin adjoined to small, coated wires that are connected to nerves within the spinal canal. Once the electrodes are in place, they are turned on to administer a weak electrical current along the nerve. The patient experiences this as a pleasant tingling sensation. By stimulating non-noxious pathway, the electrical current tricks the brain into turning off or intercepting the painful signals. The result is pain relief; with this intervention, most patients are then able to reduce or discontinue their pain medication and live normal lives.

Clinical Significance

This device is an extremely safe and effective, drug free intervention for ameliorating a variety of severe neuropathic pain syndromes. There have been positive outcomes in the treatment of many painful conditions such as sciatica, inguinal neuralgia, complex regional pain syndrome, intercostal neuralgia, carpal tunnel syndrome, postsurgical knee, and traumatic nerve compression, amongst other pain conditions. The operating frequency of electrical impulse is very important; resonance is a major factor to be avoided as there may be interference between the external electrical impulse and nerve impulse. One study found that the frequency between 28 to 42 Hz is the best operating frequency for the SCS to provide pain relief.

Outcomes

Researchers at NYC Pain Specialists, New York, NY conducted a case report study on a patient who received the Spinal Cord Stimulator after being bedridden in pain. The patient underwent the surgery in April 2015, and she describes the pain before surgery as the ‘Killer Pain’, indicating the debilitating pain that prevented her from completing activities of daily living and living independently.  The stimulator was placed in her right hip. The surgery not only helped the patient to overcome the pain, but also has given her a new sense of confidence. Post surgery she became more independent and could continue many regular activities were not previously possible for her.