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Spinal Cord Stimulation- When all else fails

Test Drive Before You Decide


Spinal cord stimulation is the best way to treat pain that cannot be treated by conventional spine surgery.  You're a candidate for Spinal Cord Stimulation if...


  • You've had spine surgery and still have pain (failed back or neck surgery syndrome)
  • You have pain that cannot be treated by spine surgery (i.e. the surgeon says your MRI does not explain the pain you're having).
  • You have pain and have failed all other treatments


And the best part of Spinal Cord Stimulation is that you get to test it out with a trial implantation and feel first hand in the comforts of your home what the stimulation feels like.


Pain signals are conveyed from the sensory receptors in your body through nerves to the spinal cord.  The spinal cord then relays these electrical signals to the brain which interprets them as pain.  Spinal cord stimulation is a proven method to "jam" or interfere with the transmission of the electrical pain signals at the spinal cord level.

 

Spinal Cord Stimulation consists of placing small electrodes through spinal needles into the epidural space.  The epidural space is the same space that women delivering babies receive injections to numb the sensation of contractions during delivery.  Through this space, the electrode is passed freely under fluoroscopic (x-ray) guidance until it reaches the target level in the lower thoracic spine (around the 8th to 10th thoracic levels).  For arm and neck pain, the electrode can be placed in the cervical spine.

 

Spinal cord stimulation occurs in two stages.  First a "trial" is preformed where 1 or 2 electrodes are placed through a spinal needle under local anesthesia, similar to a epidural steroid injection.  Because the patient is awake, the electrode can be placed and confirmed by the patient to cover the appropriate painful areas when tested during surgery.  The outside end of the electrode is secured at the skin level and the patient is sent home for up to a week to test the effectiveness of the stimulation at home.

 

Once the patient confirms that the spinal cord stimulation works, then the permanent system is implanted about 1 to 2 months after the trial stimulator has been removed. 


The permanent system entails inserting the same type of electrode into the epidural space in the same location as the trial with awake confirmation by the patient.  The electrode is then connected with a battery similar in size and design as a pacemaker battery.  The battery is implanted within a pocket in the upper buttocks.


Spinal cord stimulation is one of the few surgeries where the patient gets a "test drive" or a "trial run" of the final surgery by going through a trial.  Also the patient is awake for both surgeries so basically you know what you are getting even before leaving the operating room table.  In contrast, spinal surgery especially spinal fusions often require a large, long surgery without knowing the success of the outcome.

 

In the past, surgeons have reserved spinal cord stimulation for those patients who have failed surgery or multiple surgeries, called Failed Back Surgery Syndrome which is similar to Post-Laminectomy Syndrome.  Because Dr. Hua has expertise in both spinal surgery and spinal cord stimulation, he is able to offer patients the appropriate treatment without having to go through the traditional sequence of surgical procedures.  Thus Dr. Hua is able to recognize patients who have a lower chance of success with spinal surgery and fusion surgery, and in these cases Dr. Hua will recommend a spinal cord stimulator before spinal surgery.  On the other hand, Dr. Hua also knows when a stimulator will not work and has successfully performed spinal decompression on patients who have been referred for spinal cord stimulation.

 

The surgical techniques and technology are only successful if the surgeon's experience and expertise allows him/ her to know when to use a particular technique or tool. Spinal cord stimulation has been successfully used to treat leg pain, back pain, arm pain, neck pain, and even face and head pain. Please contact Dr. Hua for a full consultation about your pain problem.


Dr. Hua is one of the top experts in Minimally Invasive Spine Surgery as well as Spinal Cord Stimulation technology.  He completed neurosurgery residency and a fellowship in Functional and Pain Neurosurgery at Johns Hopkins Hospital.  After training he has performed over 2000 spine surgery cases in Northern and Southern California including being one of the top specialists in Spinal Cord Stimulation for the entire Northern California Kaiser Permanente system.  He also has developed the smallest incision lumbar spinal fusion system in the world and is able to perform spinal fusions through a dime sized incision.  This expertise allows him to offer the most effective surgical and non-surgical treatment for back and neck pain, whether it is minimally invasive spinal surgery or spinal cord stimulation therapy.



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Neurosurgery for Pain


Conservative Management

Physical Therapy and Epidural Steroid Injections are typical first line treatment for back and neck pain.  Conservative therapy can be given by physical therapists and chiropractors.  Epidural Injections are given by Anesthesiology Pain Specialists and Physical Medicine and Rehabilitation Doctors. We work with the most experienced therapists, chiropractors, and pain specialists.  Call our office for a referral to a therapist or pain specialists that you can trust in your area.

DimeSpine.com

SHERWIN HUA  NEUROSURGERY

SHERWIN HUA  NEUROSURGERY