Neurostimulation of the spinal cord

What is spinal cord neurostimulation?

Spinal cord neurostimulation, also known as posterior cord stimulation, consists of the surgical implantation of one or more electrodes in the epidural space or in peripheral nerves in order to send electrical impulses that inhibit painful impulses from the spinal cord.

This surgery is recommended for patients suffering from chronic pain. The pain becomes a tingling sensation (paresthesia).

Why is spinal neurostimulation performed?

Spinal neurostimulation is performed in patients suffering from chronic pain in whom other pharmacological, rehabilitative and minimally invasive treatments have failed or have not achieved the expected results.

  • Neurostimulation is recommended in patients with lumbar or cervical pain radiating to the extremities.
  • Patients with Complex Regional Pain Syndrome, Sympathetic Reflex Sympathetic Dystrophy
  • Refractory anginal pain
  • Chronic pain due to ischemia of the lower extremities.

What does medullary neurostimulation consist of?

The procedure consists of the introduction of an electrode – a wire – into the epidural space, connecting it to a generator under the skin. The generator produces low-voltage electrical signals that are transmitted from the electrode to the spinal cord or specific nerves that are causing pain.

This mechanism prevents painful pain signals from reaching the brain. Using a remote control, the patient can regulate and adjust the intensity of the stimulation.

The implant is carried out in two phases. A first test phase is used to test the stimulation system and check whether it is satisfactory for the patient and effective in mitigating or eliminating pain. The first phase is performed under local anesthesia and intravenous sedation. One or two electrodes are implanted inside the spine until they are placed on the part of the body where the pain is located. The opposite end of the electrode is connected to an external stimulator device, which will be tested little by little by the patient, checking if it is really efficient in the fight against pain relief.

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The second phase is the definitive implant, and this is done in the same way: sedation and local anesthesia. An incision is made in the buttock, abdomen or chest and a pulse generator is inserted under the skin. This is connected to electrodes in the medulla.

Spinal neurostimulation is used to treat chronic pain problems, such as low back pain.

Preparation for spinal neurostimulation

A spinal neurostimulation treatment does not require a great preparation, but it is simply a preoperative procedure, i.e., a complete blood test along with a physical examination, as well as knowing the medical history and possible medications taken by the patient.

The patient should come fasting in both phases.

Care after spinal cord neurostimulation

In the first 24 hours the patient should remain hospitalized and at complete rest. If everything has been correct, the patient will be discharged in the following hours, although the recovery process will be somewhat longer, undergoing treatment at the health center and gradually returning to daily life.

Alternatives to spinal cord neurostimulation

Spinal neurostimulation is an alternative treatment to conventional treatments to try to alleviate the problems and discomfort caused by chronic pain.

Thus, neurostimulation is itself an alternative treatment to surgery and treatment by drugs and/or therapies that have previously failed, such as treatment with drugs, therapies, physiotherapy exercises and even surgical treatment.