Dorsal Column Stimulator Implantation

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Evolution of Dorsal Column Stimulator Implantation

Neuromodulation in the spine is more commonly referred to as spinal cord stimulation or dorsal column stimulation. It involves the implantation of a small device that sends mild electrical pulses through wires (called “leads”) to specific parts of the spinal cords. These pulses mask the pain signals that are traveling to the brain.

Implantation of a spinal cord stimulator is usually a two-step process. The first step is undergoing a trial period. In this step, under local anesthesia and x-ray guidance, electrical leads are inserted close to the spinal cord. These leads are then attached to an external stimulator. Over the next week, the patient is able to adjust the intensity and duration of the stimulation, as well as power it on or off. If the trial stimulation is effective in alleviating pain symptoms, a more permanent implantation of the device and battery can occur. This next step is often performed under IV sedation, and it sometimes involves the removal of small portion of the vertebra (the lamina) to make room for the stimulator leads. A small incision is then made either in the abdomen or upper buttocks for the battery-operated generator to be implanted. Patients normally get discharged either the same day or the next day. Just like during the trial period, through a hand-held device, patients are able to control the intensity of the stimulation, as well as power it on or off.

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