Treatment by Neurostimulation
| What is neurostimulation and how does it work? |
| Neurostimulation
uses a small system that is surgically placed under the skin to send precisely controlled mild electrical pulses (which are felt as tingling sensations) to targeted areas of your nervous system. These electrical pulses are delivered through a lead (a special medical wire or thread) that is also surgically implanted. The electrical pulses block pain signals from reaching the brain, thereby alleviating the sensation of pain. As neurostimulation works in the area where pain signals travel, electrical pulses can be directed to cover the specific areas where you are feeling pain. Neurostimulation does not involve any medication, so there are very few of the side effects that may accompany drug treatments. How effective is neurostimulation? |
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| Neurostimulation
is a tested, effective1,2,3,6 alternative to repeated back surgery, medication or other pain therapies. Patients who have success with neurostimulation usually experience a 50-88% reduction in their pain and an improved ability to participate in daily activities.7,8,9 |
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Neurostimulation
can also reduce or eliminate the need for |
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Components
of a neurostimulation system The neurostimulation system is a totally implantable and programmable system, which consists of two main parts - a battery and a lead- that are both placed inside the body during an operation. The battery is usually placed under the skin of the abdomen, where |
| it is most comfortable and least visible, although your doctor will position it in the most appropriate position for you. Your doctor or nurse will use a programmer to adjust your neurostimulation system so that it effectively treats your pain. This does not require an operation. Instead, it is done via telemetry through the skin. |
| Your neurostimulation
device also comes with a patient programmer. This is a hand-held device,
similar in size and shape to a computer mouse, which allows you to change or control your own stimulation within prescribed limits set by your doctor. You can also use this programmer to turn your neurostimulation device on and off. The battery of your neurostimulation device usually lasts for 2-5 years, depending on how many hours per day the system is used, and the intensity of stimulation (the electrical pulses). When it is time to have your battery replaced, your doctor will remove the device during a minor surgical procedure and replace it with a new one. |
 Patient Programmer |
| How do I know if neurostimulation can work for me? |
| Your doctor will perform a screening test,
which will help predict whether neurostimulation will relieve your pain.
Testing for neurostimulation can be done on an outpatient basis, or you
may be admitted for a short hospital stay. The screening test consists of a simple three-step process: |
| 1. Firstly,
you will be locally anaesthetised. 2. Your doctor will then carefully insert a lead through a needle into your mid-back. This lead will be connected to an external screener that allows your doctor to adjust stimulation. 3. Finally, your doctor will ask you questions about the location and intensity of the stimulation. This process will continue until your doctor has found the best area to stimulate to reduce your pain. |
| People who do not experience adequate pain relief during the screening test will not undergo permanent implantation. |
| Is neurostimulation safe? |
| Clinical research has shown1,6,10 that the tiny electrical pulses from the neurostimulation system do not have any adverse effects on the nervous system. Research has also shown that complications associated with the implanted components are harmless and infrequent.1 Neurostimulation is reversible, meaning that, if necessary, the system can be turned off or removed. |
| Are there any side effects or complications with neurostimulation? |
| Side effects and complications with neurostimulation are rare and are seen in a small number of patients. However, neurostimulation does require surgery, and as with any surgery some risks exist. These include infection, bleeding and pain at the site of implantation. Neurostimulation does not cause drowsiness, disorientation or nausea. |
| The most common adverse events that may be experienced with the neurostimulation device itself include: |
| · No stimulation, resulting in
loss of pain relief · Intermittent stimulation · Stimulation in a wrong location · Uncomfortable stimulation described by some patients as shocking or jolting · Threshold rise, which means that neurostimulation settings have to be increased to achieve the same pain relief |
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Neurostimulation
at a glance
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How
does it work ?
What are the benefits ?
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References
1. Burchiel KJ. Spine 1996; 21:2786-94
2. Kumar K. Surgical Neurology 1998; 50:110-121
3. North RB. Neurosurgery 1993; 32:384-394
6. Segal R. Neurological Research 1998; 20:391-396
7. North RB. Neurosurgery 1991; 28:692-699
8. Van Buyten. J Neuromodulation 1999; 2:258-265
9. Ohnmeiss DD. Spine J 2001; 1:358-363
10. Kemler MA. N Engl J Med 2000; 24:1811
