Spinal cord and peripheral nerve stimulation are minor surgical procedures designed to treat intractable pain in specific parts of the body, by placing electrodes into the spinal canal (in the epidural space for spinal cord stimulation), and under the skin near peripheral nerves (for peripheral nerve stimulation), and using electricity to modify the pain impulses transmitted through the nervous system. This is designed to reduce painful sensations caused by a variety of medical conditions. Most frequently this technique is used for patients with failed back surgery syndrome (FBSS). It is also very helpful for many patients with complex regional pain syndrome (CRPS), painful neuropathies (such as post-herpetic neuralgia and pudendal neuralgia), migraine headaches, and bladder or genital pain.
The stimulator system consists of an array of electrodes which are connected via an insulated electrical wire, or lead, which is then connected to an implantable generator. There is a battery in the generator, and some of the batteries are available in a rechargeable format.
The procedure is carried out in two stages:
- The first stage is the “trial” stage, in which the electrodes are placed via a needle into the spinal canal or along the peripheral nerve, and are left in place for about a week, in order that the patient may test out the pain relief, while being able to do some routine activities that usually trigger pain.
- The second stage is carried out if the trial stage was successful. This consists of placement of the generator under the skin, in the buttock, lower abdomen, or in the chest, and attaching the generator to the electrodes underneath the skin. If the first stage was not successful in relieving the pain, the electrodes are simply removed.