NEUROSTIMULATORS

Neurostimulators are devices that are implanted into the spine and connected to internal or external generators. They are used to stimulate the nerves to disrupt pain signals reaching the spine or to cause end organs to function more efficiently, such as in bladder stimulation.

Spinal cord stimulation can be performed as a major neurosurgical procedure with open laminotomy or as a minor surgery with placement of the neurostimulator by an anesthesiologist or surgeon. The extent of local scarring, difficulty of placement and available expertise determines which procedure is to be used.

Regardless of the approach, the indications for neurostimulor placement are the same. Intractable nerve pain from injury to a nerve or nerve root, sympathetic nerve pain, unrelenting peripheral neuropathy orsevere peripheral circulatory compromise are all capable of being helped by neurostimulation.

After a neurostimulator is placed, it can be adjusted for intensity of signal and coverage pattern. Some aspects of this adjustment are left to the patient and some are controlled by the physician or stimulator team. Tiny electrical leads are placed at the end of a wire, which in turn is connectred to a generator box that determines signal strength and distribution. The generated signal is sent to the underlying spinal cord and causes mild regional paresthesias that can effectively block intractable pain signals from damaged nerves. Although this can be effective solitary treatment, it is best seen as part of an overall treatment regimen, including pharmacological, psychological and social interventions.

The devices used are constantly being upgraded with the focus being upon less invasive approaches and longer lasting effects. Once a neurostimulator is placed it is important to note that current models will need revisions every 3 to 5 years.