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Tiny Implanted Devise Blocks Tough To Treat Pain… Eon-mini Spinal Cord Stimulator

Issue 48.12

Spinal Cord Stimulation or SCS is an FDA and Medicare approved treatment that is extremely successful at treating chronic pain.  Chronic pain may prevent people from working, eating properly, engaging in physical activity or enjoying life.  As a patient dealing with chronic pain, it can take over your life.  As physicians we can usually treat pain with different types of medications, physical therapy and injections, however when these treatments inadequately treat the patient’s pain, SCS is commonly used as a very successful treatment for chronic pain.

SCS is used for several painful conditions; back, leg, or arm pain, peripheral neuropathy, nerve damage, headache, phantom limb pain, arachnoiditis (scaring of spinal nerves) and complex regional pain syndrome.  These pain conditions are commonly difficult to treat with medications and injections alone.  In my medical practice approximately 90% of patients with these painful medical conditions are able to get at least 50% pain reductions from a SCS.

So how does it work?  SCS is a pain relief technique that delivers low voltage electrical current to the spinal cord or peripheral nerve.  This low voltage current acts to “scramble” or block the pain from getting to the brain.  The brain will focus more on the pleasant buzzing or tingling sensation produced by the SCS device and thus block out the pain.

In order to see if you are a candidate for spinal cord stimulation, you must be evaluated by a pain specialist.  A thorough history and physical will be performed to correctly diagnose your painful condition.  The pain specialists will also ensure that you have tried all adequate medications and other treatments that are indicated for your painful condition.  If the pain specialist determines that you are a candidate for SCS treatment, you will first undergo a “trial”.

A SCS trial is a “test drive” to determine the level of pain relief that a patient will receive from the device.  This procedure is done as an outpatient and typically takes 30-60 minutes.  A patient is taken to an operating room or medical procedure suite and placed in the prone position.  Mild sedation is used, as two small wires are placed under x-ray guidance into the epidural space similar to a labor epidural for a woman delivering a baby.  These two wires are then taped to the patient’s skin and the patient is sent home for 3-5 days to trial the stimulation.  Medicare and most health insurances require that a patient have at least 50% pain reduction during the trial in order to qualify for a permanent SCS.  After the trial the wires are easily removed in the office.

If the trial is successful, a SCS can be implanted by a pain specialist or a spine surgeon.  The device is very small and similar to the size of a pacemaker.  Patients with SCS implants work with their doctor to continue to treat the pain and manage the SCS.  There are representatives for the two major SCS, St Jude, and Boston Scientific that live in the St. George area and help educate and manage the SCS throughout a patient’s experience of trial and implant.  A remote control is used to turn up, down or move the stimulation as well as recharge the SCS battery.  Hundreds of patients in the St. George area use a SCS to greatly improve their pain control and quality of life.

Dr. Court Empey is board certified in both Anesthesiology and Interventional Spine and Pain Medicine.  He received his training at the University of Utah and the Mayo Clinic.  He is the founder and president of Desert Pain Specialists and may be reached at 216-7000.

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