Neuromodulation for Pain

Many patients with chronic pain, significant spinal disease or neuropathic pain, and are not a candidate for a larger corrective surgery may consider spinal cord stimulation for pain treatment. Spinal cord stimulation is a non-opioid alternative for pain control, which may be used with other treatments such as physical therapy, oral or transdermal medication, injections, radiofrequency ablations, and surgeries have failed or are unable to be performed.

Spinal cord stimulation (SCS) disrupts the pain signals traveling between the spinal cord and brain. Stimulation is delivered by a neurostimulator, which is implanted under the skin. The electrical impulses travel from the neurostimulator to the spine over thin insulated wires called leads. The leads deliver mild electrical impulses at the level of the spine to interrupt pain signals between your spinal cord and brain to help you get back to the everyday activities that have been limited by chronic pain.

There are four primary manufacturers of epidural spinal cord stimulator technologies, including Medtronic, Boston Scientific, Abbott, and Nevro. The choice of which device to use is patient-dependent and often also involves the input of the patient's pain management physician. Dr. Faraji works with each of these companies when it comes to surgical implantation. Key things to consider are (1) battery life and recharge options for the battery, (2) MRI conditionality and ability to obtain advanced imaging, (3) the versatility to deliver personalized programming options that may be adjusted, (4) customer service and responsiveness of the manufacturer team if there are issues or questions regarding the stimulator system.

Dr. Faraji performs percutaneous lead placement (small spaghetti-sized wires with electrodes) for trials or permanent implantation as well as paddle lead placement via small bone openings (laminectomy) roughly the size of your fingernail. Finally, Dr. Faraji uses intra-operative neurophysiological testing while a patient is asleep with general anesthesia, which can help improve the likelihood of excellent stimulator coverage of the painful areas. This less invasive surgery uses state-of-the-art neuroscience tools to help patients achieve faster recovery to move forward with their lives!