We all suffer from back and neck pain at times in our lives. But when the pain becomes chronic, it begins to impact your life. Even simple tasks can become a painful chore.
Dr. Murphy has been helping patients deal with their pain for over three decades. He specializes in treating patients whose chronic neck and back pain has not responded to other treatments. For some of these patients, spinal cord stimulation can be a great answer.
What is spinal cord stimulation?
During spinal cord stimulation, Dr. Murphy implants thin, insulated wires in the epidural space surrounding the spinal column. A small device implanted near the spinal cord then generates mild electrical pulses that are sent down the wire leads. This electrical stimulation can modify or block the pain messages sent to the brain by the nerves.
For a visual metaphor of sorts, you can think of spinal cord stimulation as similar to implanted pacemakers that help a patient control abnormal heart rhythm.
Who would be a good candidate for spinal cord stimulation?
Patients right for spinal cord stimulation typically have had chronic debilitating pain for at least six months in the lower back, leg (sciatica), or arm. Patients will have exhausted conservative treatment options, such as physical therapy.
These are some of the general conditions or attributes that a candidate could have:
- Conservative therapies have failed.
- You seek to avoid major surgery (or another surgery) due to the risks or recovery.
- The pain is in a location where it can be managed with spinal cord stimulation.
- You do not have untreated depression or drug addiction.
- You’ve undergone a successful spinal cord stimulation trial.
This procedure with Dr. Murphy may not be suitable for patients with an infection, especially if it is in the area of the intended site for the stimulation device or if it affects the patient’s entire body. These procedures are not available for patients with a demand-type cardiac pacemaker, as well.
How is the spinal cord stimulator implanted?
Before implanting the stimulator device, patients must have a trial period. This involves Dr. Murphy inserting the leads but not the transmitter. For the test period, the leads are attached to an external transmitter that the patient wears outside the body.
To implant the leads, patients receive local anesthesia usually in combination with sedation. The patient is placed on his or her stomach and Dr. Murphy inserts a hollow needle into the epidural space. The leads are passed through this needle. The patient is awake, and Dr. Murphy then gets feedback on the placement of the leads. When the pain initiating areas have been covered, the leads are connected to the external neurostimulator, which is worn on a belt.
This trial period lasts about one week. If the patient experiences significant pain relief and wishes to progress to permanent implantation, Dr. Murphy then moves to implant the stimulator. If the patient didn’t feel the procedure has provided the pain relief they seek, the leads can be removed.
For the permanent placement, Dr. Murphy follows the same initial process, implanting the permanent leads into the epidural space. Next, he implants the generator via a small incision. Generators can vary in size, the largest being about the size of a stopwatch. The generator can be implanted in the abdomen, upper buttocks, or upper chest, according to the patient’s preference. It is placed between the layers of skin and the muscle beneath. Wires are then tunneled through the body from the leads to the generator. Patients are given a controller to adjust the stimulation as needed.
The generator is not visible under clothing. These devices typically last between 10 and 25 years.
Is there recovery after the placement of the spinal cord stimulator?
This is a minimally invasive procedure with Dr. Murphy, but there is still a recovery period. To keep initial pain to a minimum, and to keep the leads from migrating, certain physical activities will need to be limited for about three months. We will discuss these with you. Light activity can usually be resumed in two to three weeks. Full recovery will take from six to eight weeks.
What are the risks involved with spinal cord stimulation?
No surgery is without risks. Although minimally invasive, this is surgery with Dr. Murphy, so it includes all the risks involved with any surgery: excessive bleeding, infection, development of blood clots, reaction to anesthesia, and the like. These are very rare with this procedure.
There are risks specific to this procedure:
- Cerebrospinal fluid leak
- Undesirable changes in stimulation (can result from cellular changes in tissue around the electrodes, movement of the electrode, loose electrical connection, and/or lead failure)
- Battery failure
- Battery leakage
- Persistent pain at the electrode or stimulator site
- Development of a seroma at the implant site (can usually be drained)
- Lead migration
- Allergic response to the implant materials
- Generator migration and/or local skin erosion
- Paralysis, weakness, clumsiness, numbness, or pain below the level of implantation
What is the success rate of spinal cord stimulation?
Dr. Murphy carefully screens patients before deciding upon this treatment option. This procedure doesn’t cure the patient’s condition that is causing the pain, it simply allows the patient to manage the pain. Spinal cord stimulation is considered to be successful if the patient’s pain is reduced by at least 50 percent.
There have been numerous studies on the effectiveness of spinal cord stimulation, and they show good to excellent long-term relief in from 50% to 80% of patients suffering from chronic pain.
Also, should the patient at some point desire to discontinue this treatment, the procedure is reversible.
Schedule Your Consultation Today
If you're interested in learning more about Spinal Cord Stimulation please contact us for a consultation at 210-247-6362 or fill out our contact us form. We will discuss your needs and concerns, and determine your best course of action.