One of the more controversial areas of the surgical treatment of pain in recent years has been the implantation of electronic devices into the body to stimulate the nerve pathways directly in the spinal cord. Such devices, known as spinal cord or dorsal column stimulators, have been implanted into patients’ spines over the past ten years.
Fine gold electrodes are inserted into the spine through an incision over the vertebral column. At first these are connected to an external computerised electrical stimulator while it is assessed for accuracy of location in the spinal canal and different stimulation methods are tried.
When it is found to be successful the patient undergoes a second stage of the operation in which a battery powered electronic stimulator is implanted under the skin of the patient’s chest or abdomen. After this has been done the patient uses a powerful radio device to send messages to the stimulator and direct the current being delivered, its strength and pattern of stimulation.
The success of such treatment varies according to which surgeon is reporting his, or her, success. But there is a certain degree of scepticism about the procedure from some of the innovators of the technique who have subsequently stopped performing it. Unfortunately, one of the major complications of the treatment is infection in the location of the fine electrodes — in the spinal canal. This usually leads to the removal of the $5000 stimulator unit which cannot be reused on other patients. Another unfortunate problem is the unexplainable loss of effectiveness which occurs in a previously helped patient — typically within the first six months of treatment.
A second opinion Those who are offered this form of therapy should always seek a second opinion. At best, it is an uncomfortable operation, at worst it is potentially harmful and fraught with postoperative problems.
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