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Spinal Cord Stimulation for Pain from Spinal Cord Injury

Spinal Cord

Spinal Cord Stimulation

Spinal Cord Stimulation has long been an advanced procedure for chronic pain, including the pain that can occur from spinal cord injury. There is vast research that shows safety and efficacy of spinal cord stimulation for a multitude of painful diseases, that have been grouped together, and approved by the United States FDA as “chronic pain of the trunk and the extremities.” Since the advent of spinal cord stimulation, technology has improved early on with lead and contact designs, and most recently by software improvements. With each improvement in design, more and more patients can gain pain relief, that past designs may have failed to provide. Due to the technology and its surgical insertion, many pain doctors are still apprehensive to recommend this, since it is a labor intensive to provide. Insurance reimbursement is also a challenge. But, for those pain doctors and clinics that do offer spinal cord stimulation, it is a highlight of their practice due to the satisfaction they receive from excellent patient outcomes.

Spinal Cord Injury

More than 2.5 million people currently live with chronic spinal cord injury (SCI) with more than 130 000 newly afflicted individuals each year worldwide. 1 Pain with spinal cord injury can be devastating. It commonly interferes with the patient’s ability to participate in the activities that would otherwise make life full. This limitation may be playing with children, getting out of the home, or even keeping up with their home activities/tasks. Many times moderate to severe pain occurs at the “transitional zone,” at the location of the body where the cord is damaged. Many patients try creams, physical therapy, medications- even controlled substances, but do not get the pain relief they need to start living a full life again. These patients need to have exposure toSpinal Cord Stimulation.

Spinal Cord Stimulation Outcomes with Spinal Cord Injury Pain

Currently, Spinal Cord Stimulation is available in the USA with 4 major manufacturers, and each of these has launched a new product approximately every 2-5 years. These new products have made pain relief better each time. A few advancements that have recently been accomplished are:

  1. MRI Safe Implants (ability to get MRI when these are implanted)
  2. High Frequency Programs
  3. Burst Stimulation
  4. A.S.T. (Fast Acting Subperception Therapy)

For further information go to, an also click the manufacturer’s links on our webpage:

https://www.michiganpainspecialists.com/contents/procedures/spinal-cord-stimulators

In this author’s experience, 95% of patients with Chronic Spinal Cord Injury have improved with Spinal Cord Stimulation. Of these >50% pain relief is the goal, and the average relief is 75%. Patients interested need to understand that this is not intended to help numbness, nor weakness, and provides pain relief only. Understanding the world of spinal cord stimulation can easily become confusing. Learning about this online is the goal of this article. After online searches, patients can seek out a pain doctor who specializes in spinal cord stimulation. There are many pain doctors that are capable, but going to a doctor that has high volume of this treatment is much preferred to ensure the best outcomes.

Spinal Cord Stimulation Insurance Coverage

The vast majority of health insurances policies cover this procedure. It may require significant experience to understand the correct billing steps, which is another benefit to seeking pain doctor groups that perform high volumes of this procedure.

 

References:

  1. Neurorehabilitation and Neural Repair 2016, Vol. 30(10) 951–962
Author
Louis D. Bojrab, MD, FIPP Interventional Pain Specialist at Michigan Pain Specialists, PLLC

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