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.
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.
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.
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.
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