Spinal cord stimulators and
pain pumps - implantable systems for neuropathy
Advanced treatments for neuropathic pain
(neuropathy)
When oral medications and/or nerve blocks do not sufficiently control the pain,
advanced pain therapies or implantable systems may be effective for treating
neuropathy. These systems are designed to interrupt transmission of pain signals
from the spinal cord to the brain. If the neuropathic pain signals do not reach
the brain, then the patient does not actually feel the pain.
- Spinal cord stimulation (SCS) for
pain control introduces low levels of electrical
current to the dorsal portion of the spinal
cord to block the sensation of pain. The device
is implanted during a surgical procedure, and
may include a fully implanted system or a system
with an external power source.
Spinal cord stimulators may be used to manage pain from failed back surgery
syndrome or radiculopathy (sciatica or leg pain). Current medical literature
indicates that 50 to 60 percent of patients will get a 50 percent or better
pain relief with this procedure that has lasted up to 20 years post implant.
- Spinal pumps (or pain pumps) delivers
pain medication (typically morphine) directly
to the intrathecal space around the spinal
cord via an implanted pump. The pump is implanted
during a surgical procedure, and medication
in the pump is added periodically (e.g. monthly)
by injecting medication through the skin into
the pump reservoir.
Spinal pumps may be used to manage chronic pain from osteoporosis or axial
somatic pain (nociceptive pain), and sometimes may by used to manage pain
from failed back surgery syndrome (although the efficacy for this use is
unclear). Spinal pumps are also used to treat painful spasticity as is seen
in multiple sclerosis.
Often multiple medications are put into the pump to treat certain specific
situations. That is, morphine to treat the nociceptive pain and local anesthetics
(such as bipuvicaine) to treat a neuropathic pain component.
For each of the above procedures, a trial is
first performed to see if it is effective and
how the patient reacts before the surgery is
performed. Both of the procedures are reversible
and the implantable system can be removed. |
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