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Why Patients Get Spinal Stimulators

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Why do patients get spinal stimulators?

Spinal stimulators, or spinal cord stimulators, are medical devices designed to help patients with chronic back pain. These implanted devices work by sending a gentle pulse that changes the way the brain processes pain signals.

Often, chronic pain can be a vicious cycle. Inactivity because of pain can lead to decreased mental health and declining physical fitness that can make pain worse. For patients dealing with severe and debilitating back pain and related symptoms, spinal stimulators can help with a return to daily activities and breaking cycles of inactivity and a sedentary lifestyle.

If you’re exploring potential treatments for chronic pain and want to know whether a spinal stimulator is right for you, take a moment to read the following guide. By having a better understanding of spinal cord stimulator devices and procedures, we hope you’ll be able to make an informed decision about your care to help you reach your treatment goals.

What is a spinal cord stimulator?

Typically, a spinal cord stimulator is an implanted device that consists of a small power pack attached to two electrodes at the end of very thin wires. The wires travel from the power pack to the epidural area of the spine, where they transmit a gentle electronic pulse to the pain area. The battery pack is implanted by surgeons under the skin, either in the abdomen or in the lower back near the buttocks.

While medical researchers are still learning about the specific mechanism, spinal stimulators essentially disrupt pain signals as they travel to the brain. Instead of pain, patients often report experiencing a light tingling sensation.

Generally, spinal stimulators involve two procedures. The first is a trial where only the electrodes are implanted to determine if the electrical stimulation is effective. If a patient experiences relief, the follow-up procedure will place the full implanted device underneath the skin. These procedures are generally minimally invasive and performed on an outpatient basis. The procedure itself typically takes one to two hours and patients can move around soon after and return home on the same day.

Three indicators that a spinal stimulator is right for you

Not every patient is a candidate for spinal cord stimulator, it is generally recommended for patients with specific conditions who are at a specific point of treatment. Here are three primary indicators that cause physicians to recommend a patient for spinal stimulator implant procedures:

 

  • You have debilitating chronic pain related to a spine condition or other problem — spinal stimulators can offer relief for a range of spine conditions, including bulging and herniated discs, spinal cord injury, nerve compression and arachnoiditis as well as other conditions such as angina and diabetes. Symptoms such as pain, numbness and muscle weakness can make it extremely difficult to accomplish daily activities and can severely diminish quality of life. However, in many cases, patients are able to successfully manage these symptoms through initial conservative treatments. 
  • You have fully explored conservative treatments — For many people dealing with chronic pain, conservative options such as medication, physical therapy, injections and lifestyle changes can be highly effective. For others though, weeks and months can pass without finding the relief necessary for a normal activity level. Depending on the specific circumstances, a doctor may recommend a spinal stimulator procedure or another type of surgery.
  • You have undergone spine surgery but are still suffering from chronic pain — Not all patients who receive spinal stimulator devices have previously undergone back surgery, but many have. Whether a patient chooses not to undergo a followup back surgery or they are not deemed a good candidate by doctors, a spinal cord stimulator can be an effective alternative for patients who still experience pain after surgery. Because spinal cord stimulators have an initial trial, patients can have more confidence that the procedure will provide effective relief for the pain area..

 

Patients who meet all or some of these indicators may be candidates for spinal stimulators. By meeting with a surgeon for a consultation, you can find out next steps for relief.

Spinal stimulator procedures at USA Spine Care

At our state-of-the-art outpatient facilities, patients can undergo spinal stimulator procedures on an outpatient basis that offer lasting relief. From consultation, to trial, to final procedures that place the implanted device, you can expect a streamlined patient experience that puts you at the center of care. Upon recovery, you will be given full postoperative instructions and any lifestyle changes required for the new device. Recovery is usually minimal, with typical recommendations being lighter activity for the first two weeks after surgery.

USA Spine Care works with most major insurance providers, Medicare, workers’ compensation claims and personal injury cases. If you have any questions or would like to learn more about finding lasting relief for chronic pain, contact our caring and dedicated team today.

Call toll free 1-866-249-1627.

Spinal Cord Stimulator - People Also Ask

Spinal cord stimulator implants are covered by Medicare and are billed under:

  • Percutaneous Leads and Extensions
    63650 Percutaneous implantation of neurostimulator electrode array, epidural
    63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
    63663 Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
  • Paddle Leads
    63655 Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural
    63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
    63664 Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
  • Stimulators
    63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
    63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver
  • Analysis and Programming
    CPT codes 95970–95973 are used to report electronic analysis services. These are not considered medically necessary when provided at a frequency more often than once every 30 days. More frequent analysis may be necessary in the first month after implantation.

Published studies of spinal cord stimulation show good to excellent long-term relief in 50 to 80% of patients suffering from chronic pain. One study reports that 24% of patients improved sufficiently to return to gainful employment or housework with stimulation alone or with the addition of occasional oral pain medication.

Unlike a spinal fusion, a spinal cord stimulator surgery is reversible. If a patient decides at any time to discontinue, the electrode wires and generator can all be removed.

Spinal Cord Stimulation is an option for those suffering from chronic, intractable pain of lower back and/or limbs including unilateral or bilateral pain associated with the following conditions:

  • Failed Back Surgery Syndrome (FBSS)
  • Radicular pain
  • Post-laminectomy pain
  • Multiple back surgeries resulting in continued or worsening pain
  • Unsuccessful vertebral disk surgery
  • Degenerative Disk Disease
  • Peripheral causalgia
  • Epidural fibrosis
  • Arachnoiditis
  • Complex Regional Pain Syndrome (CRPS)
  • Causalgia

No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. Specific complications related to SCS may include:

  • Undesirable changes in stimulation (can possibly be related to cellular changes in tissue around electrodes, changes in electrode position, loose electrical connections, and/or lead failure)
  • Epidural hemorrhage, hematoma, infection, spinal cord compression, and/or paralysis (can be caused by placing a lead in the epidural space during a surgical procedure)
  • Battery failure and/or battery leakage
  • Cerebrospinal fluid leak
  • Persistent pain at the electrode or stimulator site
  • A pocket of clear fluid (seroma) at the implant site. Seromas usually disappear by themselves but may require a drain.
  • Lead migration, which can result in changes in stimulation and reduction in pain relief
  • Allergic response to implant materials
  • Generator migration and/or local skin erosion
  • Paralysis, weakness, clumsiness, numbness, or pain below the level of implantation

In a spinal cord stimulator trial, temporary electrodes are placed and then the patient uses an external device to generate electrical current. The electrodes are placed under x-ray guidance with the patient lying on his belly. A local anesthetic is used to numb the skin and deeper tissues. The electrical wire or lead contains a series of four to eight evenly spaced electrodes that can be programmed to generate an electrical field. A spinal cord stimulator trial period is at least 5 to 7 days. This gives you time to test the device and evaluate its effectiveness managing your pain at rest and during activity

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