DORSAL COLUMN STIMULATOR
WHAT IS A DORSAL COLUMN STIMULATOR?
A Dorsal Column Spinal Cord Stimulator is basically a electrode wire that is placed in the epidural space (space outside the spinal cord) that sends small electrical signals to the spinal cord. These signals can interrupt and replace pain signals.
AM I A CANDIDATE FOR A DORSAL COLUMN STIMULATOR?
You may be a candidate if you have chronic leg, arm, or back pain that has not been able to be controlled with other modalities. Other diseases treated are CRPS (chronic regional pain syndrome/RSD/causalgia,) vascular insufficiency, inoperable angina, and failed back surgery syndrome.
HOW LONG DOES THE PROCEDURE TAKE?
You will first undergo a trial where temporary wires will be placed in the epidural space connected with a battery pack with which you can adjust the stimulation. This stimulator trial will last for 3-5 days. If this trial is successful in reducing your pain by more than 50%, then you will come back for a permanent implant to place the generator under the skin. This will be done in an operating room generally as an outpatient. The procedure can take several hours.
WILL THE PROCEDURE HURT?
For the stimulator trial, we will use numbing medicine to the skin and underlying tissues. Most patients will also receive sedation and analgesia to help you relax. For the permanent implant in the operating room, you will receive deeper sedation (twilight sleep) to implant the impulse generator (battery) under the skin.
HOW IS THE PROCEDURE PERFORMED?
You will be lying on your stomach on an x-ray table. We will monitor your blood pressure, heart rhythm, and blood oxygen. Your skin will be cleansed with an antiseptic. After the procedure, you will be placed on a bed and moved to the recovery area where programming of the generator will take place.
WHERE ARE THE WIRES INSERTED? WHERE IS THE GENERATOR PLACED?
If your pain is in your low back or legs, the wires will be placed in your low back. If your pain is in your arms or chest, the wires will be placed in your upper back. The generator is generally placed in the upper buttock or side of the hip for the permanent implant.
WHAT SHOULD I EXPECT AFTER THE PROCEDURE?
If the procedure is successful, you may feel that your pain is replaced with a tingling or buzzing sensation that is not unpleasant. You may have an area of soreness from the needle placements for a couple days.
WHAT SHOULD I DO AFTER THE PROCEDURE?
Most patients are sent home after the procedure unless otherwise indicated. You will be advised to take it easy the day of procedure and you will not drive yourself. After the first day, you will be able to do activities as tolerated.
HOW LONG WILL THE GENERATORS LAST?
Depending on the type of battery implanted and the amount of stimulation used, the battery may last from 2-7 years and then will need to be replaced.
WHAT ARE THE RISKS AND SIDE EFFECTS?
Overall, the procedure is very safe. As with any procedure, there are risks. The most common side effect is pain, which is temporary. Any time a needle is punctured through the skin, there is a chance of bleeding or infection that is very rare. Other rare side effects include spinal headache, nerve damage, worsening of pain, etc., which are extremely unlikely. Please discuss your concerns with your physician.
WHO SHOULD NOT HAVE THIS PROCEDURE?
You should not have this procedure if you are currently taking any blood thinning medications (Plavix, Coumadin, Warfarin) or if you have an active infection.
WHERE CAN I GET ADDITIONAL INFORMATION?
You can find additional information on Medtronics™ Website.