Spinal cord stimulation is a type of neuromodulation that effectively treats neuropathic (nerve-related) pain. It involves placing a tiny electrical wire (electrode) near the spinal cord; this is connected to an electrical device (pulse generator) that sends out small electrical impulses to reduce the feeling of pain.
What is it used to treat?
This highly-targeted method of neuromodulation can be used to treat specific sites of pain in the body (such as after back surgery that has been ineffective) or more generalized pain (such as with complex Regional Pain Syndrome).
Post Laminectomy Syndrome
Post-laminectomy syndrome is a condition where the patient suffers from persistent pain in the back following surgery to the back. This article reviews this condition in a bit more detail.
A laminectomy is a procedure where a part of the vertebra that protects the spinal-cord is removed. It is usually performed to relieve pressure on the spinal-cord from a protruding disc. Very often, following a laminectomy, patients recover without any complications. However, in a small group of people, back pain and sometimes leg pain may persist following laminectomy. This persistent pain is called post laminectomy syndrome. Post-laminectomy syndrome is also called Failed Back Surgery Syndrome, or FBSS.
Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a misnomer, as it is not actually a syndrome – it is a very generalized term that is often used to describe the condition of patients who have not had a successful result with back surgery or spine surgery and have experienced continued pain after surgery. There is no equivalent term for failed back surgery syndrome in any other type of surgery (e.g. there is no failed cardiac surgery syndrome, failed knee surgery syndrome, etc.).
There are many reasons that a back surgery may or may not work, and even with the best surgeon and for the best indications, spine surgery is no more than 95% predictive of a successful result.
The Complex Regional Pain Syndrome (CRPS) is defined as a chronic condition characterized by a severe pain following injury to the bone and soft tissue.
The key characteristic of CRPS is the continuous intense pain, out of proportion to the severity of the injury. CRPS most often affects one of the arms, legs, hands or feet.
Often the pain associated to CPRS has been seen spreading to the entire arm or leg, even though the initiating injury might have been only to a finger or toe. Sometimes, pain even travels to the opposite extremity.
CRPS can occur at any age, but a greater incidence has been seen in the age group of 40 and 60, especially amongst women.
Types of CRPS
CRPS generally occurs in two types, having similar symptoms but different causes. These include:
Type I: Earlier known as reflex sympathetic dystrophy syndrome (RSD), this type occurs after an illness or injury that did not damage the nerves in the affected limb directly.
Type II: Once referred to as causalgia, this type of CRPS follows a distinct nerve injury.
Diagnosis and Treatment
Various diagnostic tools employed to detect the presence of CRPS include thermography, sweat testing, x-rays, electro diagnostics and sympathetic blocks.
The treatment modalities for CRPS center on relieving painful symptoms, as no generic cure is known for the disease. Treatment plan is aimed at helping the patients get on with their normal lives.