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Doctor Q&A with Dr. Richard Brouillette: Answers on Spinal Cord Stimulation

National Spine & Pain Centers’ Dr. Richard Brouillette from Waldorf, Maryland office answers questions about spinal cord stimulation.

Q: What exactly is spinal cord stimulation?

A: Spinal cord stimulation (SCS) is a minimally invasive treatment that disrupts the body’s ability to send pain signals and replaces them with a more pleasant tingling sensation.

Q: How does it work?

A: Using x-ray (fluoroscopic) guidance, we insert small, flexible wires into the epidural space along the spinal cord. These wires have electrical leads on their tips. We then connect the wires to a small external generator that sends mild electrical pulses that disrupt the brain’s ability to process pain signals.

Q: Who controls the sending of those pulses?

A: You do! That’s the benefit of Spinal Cord Stimulation: it allows the patient to manage their pain in real-time. You will be given a small remote control through which you can turn the current on and off or adjust the intensity of the signals.

Q: Is Spinal Cord Stimulation effective?

A: Every patient’s pain is unique, but studies show that 85 to 90 percent of those who choose Spinal Cord Stimulation report a 50 to 70 percent reduction in overall pain. Advances in the technology have made this treatment even more effective than it was just a few years ago.

Q: Is the pain relief permanent?

A: We always start with a trial implantation, to be sure that the SCS will be effective and tolerated by the patient. Trials usually last for a few days or a week. If the results are positive, we can implant a permanent stimulator. And if, over time, the treatment is no longer needed, we can remove the electrical wires.

Q: What are the benefits of Spinal Cord Stimulation?

A: The most obvious benefit is a reduction in chronic pain and the resulting ability to resume normal daily activities. That pain relief can also lead to a decreased need for pain killers, which is another huge benefit.

Q: Do I have to go to the hospital to have the procedure?

A: No. We can implant a spinal cord stimulator in our sterile office procedure suites under local anesthetic. The entire process generally takes about an hour.

Q: What conditions can benefit from Spinal Cord Stimulation?

A: Spinal Cord Stimulation can be an effective treatment option for patients who are suffering from chronic pain due to conditions such as Complex Regional Pain Syndrome (CRPS), Post-Laminectomy Syndrome (also known as failed back surgery syndrome), diabetic neuropathy or spinal stenosis.

Q: When should I consider Spinal Cord Stimulation?

A: Anyone who has been dealing with pain that lasts more than a few weeks should always consult a pain specialist. I have undergone additional training and completed a fellowship in this sub-specialty of anesthesiology and am able to correctly identify and diagnose many conditions that may be overlooked by other practitioners.

This is especially true with regard to Complex Regional Pain Syndrome. This condition is frequently misdiagnosed, leading to a critical delay in proper treatment. Sometimes, spinal fusion or carpel tunnel surgery can trigger hypersensitivity in the nervous system that can lead to CRPS, but even something as simple as a twisted ankle can lead to a slow progression of pain that can ultimately lead to significant impairment.

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