A back stimulator implant is a device that relieves back pain by sending low-level electricity directly to the spinal cord. This stimulator comes in handy when other non-surgical pain treatment methods do not offer sufficient relief from back pain. The back stimulator implant can improve your overall quality of life, reduce the need for pain medication, and improve your sleep quality. Experts use back stimulator implants alongside other pain relief treatments. Contact LAMIS to learn more about back stimulator implants in Los Angeles, including whether you are a good candidate for the procedure.
Understanding Back Stimulator Implant And How It Works
A back stimulator implant has the following components:
- Thin wires known as electrodes.
- A tiny pacemaker-like battery pack known as the generator.
The electrodes are positioned between your spinal cord and the vertebrae in an area known as the epidural space. The generator is placed beneath the skin, usually near the abdomen or the buttocks. When you have a back stimulator implant, you can use a remote control to send electrical impulses to the spinal cord whenever you feel pain. The remote control and the antennae are outside your body. Experts have not clearly explained the science behind spinal cord stimulation. What is evident is that the stimulation can target multiple muscle groups in the spine. The stimulation can also alter how your brain senses pain.
The conventional back stimulators replaced the pain sensation with a light tingling called paresthesia. However, for some patients, this paresthesia is uncomfortable. The newer back stimulator implants provide sub-perception stimulation the patient cannot feel. Highly specialized physicians place these latest back stimulator implants under X-ray or ultrasound guidance.
What Back Stimulation Is Used For
Physicians recommend back stimulation when other non-surgical pain management methods fail to work or provide relief. Back stimulation can be used to manage different types of pain, including:
- Back pain, mainly neck pain, if it persists even after surgery. This is usually known as failed back surgery syndrome.
- Heart pain, also called angina, is untreatable by other pain management methods.
- Post-surgical pain.
- Injuries on the spinal cord.
- Arachnoiditis – This is a painful swelling of the arachnoid. The arachnoid is a thin membrane surrounding the brain and the spinal cord.
- Peripheral vascular disease.
- Nerve-related discomfort or pain, including cancer-related neuropathy after radiation, chemotherapy, or surgery.
- Nerve-related pain could also include serious diabetic neuropathy.
- Pain after amputation.
- Complex regional pain syndrome.
- Perineal pain and visceral abdominal pain.
Back stimulation can improve your sleep, reduce reliance on pain medication, and improve your overall quality of life. Doctors use back stimulator implants alongside other forms of pain medication, including exercise, medications, relaxation methods, and physical therapy.
Candidates For Back Stimulator Implant
Like all other treatments, not all people are good candidates for back stimulator implants before recommending this treatment. Your doctor must ensure that back stimulation is appropriate for you. This treatment should only be used if it will provide you with significant relief from chronic back pain. Some insurers recommend psychological screening to ensure that conditions like anxiety and depression are not worsening back pain.
Every patient is unique. Therefore, doctors use no set criteria to determine who should or should not receive a back stimulator implant. The patients who reap the most out of back stimulator implants include:
- People who have not received sufficient pain relief despite using other methods like medications, less-invasive therapies, or previous surgeries.
- People who do not have psychiatric disorders that can reduce the effectiveness of a back stimulator implant.
Back Stimulator Types
There are three main types of back stimulators:
Conventional Implantable Pulse Generator
Abbreviated as IPG, this back stimulator is battery-operated. A physician places a battery in the spine during an operation. When the battery runs out, the patient must undergo another surgery to replace the battery. If you have pain in only one body part, this stimulator can be a good option because of its low electrical output.
This stimulator works in the same way as the conventional stimulator. The only difference is that when the battery runs out, it can be recharged without the patient undergoing another surgery. This stimulator can generate more electricity because it has a rechargeable energy source. This back stimulator can be a good option if you have pain in your lower back or one or two legs because its electrical signals can go further than those of a conventional stimulator.
This stimulator uses a battery located outside the body. Due to better technology and newer stimulator designs, radiofrequency stimulators are rarely used today. Like the rechargeable IPGs, the radiofrequency stimulator has a rechargeable battery. Given its power, it is ideal for people with lower back or leg pain.
When you receive a back stimulator implant, your physician will explain how to use the device, including adjusting the electric signal intensity. All three stimulators outlined above allow you to adjust the electrical signal intensity.
Different body parts or pain locations will call for varying stimulator settings. One setting can work better for walking and another for sitting. Patients can access the most commonly used settings because most devices allow physicians to save several preset programs.
Most newer versions of back stimulator implants offer several waveforms for electricity delivery:
- High-density stimulation.
- High frequency.
Back Stimulation Surgery
You will undergo two procedures when acquiring a back stimulator implant: trial and implantation.
Back Stimulator Trial
This initial step is the trial procedure. Your surgeon implants a temporary stimulator for you to try it out. The surgeon places the implant, guided by a type of x-ray known as fluoroscopy. Your surgeon will place the electrodes in the epidural space of your spine. The specific place where the surgeon will place the electrodes along the spine will depend on the location of your pain. When positioning the implant, your physician can ask for your feedback to enable them to position the electrodes in the best location.
During the trial procedure, the physician only makes one incision in your lower back to place the electrodes. The battery or generator will be outside your body, usually on a belt you wear around your waist.
You will assess how effectively the device reduces your pain for a defined period, usually one week. The trial succeeds if you experience more than 50% or higher pain reduction.
If the trial is unsuccessful, your doctor will remove the wires without damaging the nerves or the spinal cord. If the trial is successful, your doctor will schedule surgery to place the permanent back stimulator implant.
Back Stimulator Implantation
The doctor places a generator below the skin during the permanent implantation procedure. The doctor also replaces the trial electrodes with sterile electrodes. Unlike the trial electrodes, the permanent electrodes are anchored by sutures to reduce movement. The implantation is usually an outpatient procedure that typically takes one to two hours. The permanent implantation procedure is an outpatient procedure.
The procedure starts with the administration of local anesthesia. The surgeon then makes a single incision, usually along the lower abdomen or your buttock, to hold the generator. Your doctor then makes another incision to place the permanent electrodes along the spine. The incisions are about the length of a driver’s license. During the procedure, your doctor uses fluoroscopy to determine where to place the electrodes.
Your doctor will close the incisions when the electrodes and generator are well connected and running. The surgeon can provide sedation to ensure you are comfortable and relaxed during the procedure. When placing the electrodes, the surgeon will likely request your feedback to ensure that the electrodes are optimally placed.
Recovery After Back Stimulator Implantation
Most people leave the hospital the same day after a back stimulator implantation. However, waiting until the anesthesia wears off before you leave the hospital is advisable. The incisions can be painful for the first few days following the surgery. Avoid twisting, stretching, or reaching; this could pull or strain the incisions. Your doctor will likely place dressings over the incision sites. The dressings can be removed after around three days. The incisions will usually heal within two to four weeks following the surgery.
Your doctor will discuss the recovery plan, including what you should and should not do. Generally, you can engage in light activities two weeks after the surgery. You can drive again and resume work when your surgeon advises that you can resume regular activity.
Back Stimulator Implant Complications
The complications of back stimulator implants are rare. However, back stimulator implantation has some risks, like every other medical procedure. Some patients can experience the following complications:
- Infection, which is likely to occur within the first two to eight weeks after the procedure.
- Device damage due to intense physical activity or a fall, which can break the stimulator.
- Device migration is where the electrodes move from their initial location, and the stimulator fails to block pain effectively. If this happens, a patient must undergo follow-up surgery to put the electrodes back in their rightful place.
- Dural puncture — The dura mater surrounds your spinal cord. Physicians insert a back stimulator implant in the epidural space, outside the dura mater. The cerebrospinal fluid can leak out if an electrode or needle goes too far and pierces the dura mater. This puncture could result in severe headaches.
- Spinal cord trauma — Although rare, inserting a back stimulator implant can cause severe nerve damage and paralysis.
How To Live With a Back Stimulator Implant
The pain relief that most patients experience after having a back stimulator implant placed enables them to do much more and live a richer life than they would before the surgery. However, you should be careful after the placement of a back stimulator implant:
Back Stimulator Implant, X-rays, And CT Scans
X-rays and CT scans are safe, provided your back stimulator implant is powered off. Before you undergo any scan, you should inform your doctor or nurse that you have a back stimulator implant.
Back Stimulator Implants And MRIs
It is not always safe to undergo an MRI when you have a back stimulator implant. Some newer back stimulator implants are compatible with certain MRI machine models. However, the medical expert must first consider the specifics of your back stimulator implant to determine whether it is safe for you to undergo an MRI. MRIs can cause severe injuries if your back stimulator implant is not MRI-compatible.
Before you undergo an MRI, you should first consult your pain specialist. The specialist will determine whether the procedure harms or interferes with your stimulator model.
Driving With A Back Stimulator Implant
You should switch off your stimulator implant when driving or operating a heavy machine. Sudden changes in stimulation levels can cause distractions, which could cause accidents.
Whether Your Stimulator Will Set Off Airport Security
Yes, the devices at airport security gates will detect your stimulator. However, your doctor will give you a special identification card to bypass the security systems. Sometimes, you can find that the airport security gates cause uncomfortable interference with your stimulator. The good news is that this interference is harmless. If you must pass through a security scanner, you should consider turning your stimulator off before you step through.
Swimming With a Back Stimulator On
When you have a permanently implanted generator, it is safe to swim. However, you should avoid swimming if you have a temporary stimulator to avoid getting it wet. You must avoid baths, showers, and swimming pools during the short trial period.
Whether a Back Stimulator Implant Can Be Removed
If you are unsatisfied with the pain relief your back stimulator implant offers, you can have it removed. You can also remove the stimulator if the device has a mechanical issue or you develop an infection.
Find a Back Stimulator Implant Near Me
Have you suffered chronic back pain despite trying non-invasive pain relief procedures?
A back stimulator implant could be what you need. To learn more about back stimulator implants, how they work, and their effectiveness, contact LAMIS at 310-734-6088 to speak to one of our Los Angeles experts.