Spinal Cord Electrical Stimulation in the Treatment of Severe Neuropathic Pain
In one of my recent posts, I reported on a spinal cord test stimulation procedure. A link to that post will be in the first comment.
Today, I can share the results of this clinical case, which has now been completed in its surgical phase.
Clinical Case
The patient was a 21-year-old serviceman, our defender, who sustained a shrapnel wound to the abdominal organs and the third lumbar vertebra, with a metallic foreign body lodged in this vertebra.
One of the consequences of the injury was persistent, exhausting burning pain in the lower back and legs.
Test Stimulation
During the test stimulation, a temporary electrode was implanted into the epidural space (above the spinal cord membranes) at the level of the ninth and tenth thoracic vertebrae.
Stimulation of the spinal cord pathways induced sensations of paresthesia (tingling, “pins and needles”) precisely in the area of the body where the patient experienced pain.
These sensations completely “overrode” the pain.
Given the positive test results, two permanent epidural electrodes were implanted during the main surgery.
Procedure Features
Procedure Features- The electrodes are placed under the skin and connected to the neurostimulator.
- The neurostimulator is charged through the skin using radio waves transmitted by a special charging device.
- The patient controls the stimulator independently using a remote, similar to a TV remote.
- Since the intensity of stimulation varies depending on body position (increasing when lying down and decreasing when sitting or standing), the patient can adjust the settings according to their needs.
The results exceeded the expectations of both the patient and the doctors.
Patient’s Feedback:
“Why didn’t any doctors tell me that such a treatment method exists?”
The possibility of this treatment and the necessary equipment were found and purchased by the patient’s unit’s patronage service.
Olena Tolkachova, deep gratitude to you and your colleagues for this!
Mechanism of Spinal Cord Neurostimulation
If we bump ourselves, we instinctively start rubbing the affected area, and the pain subsides faster. This everyday observation illustrates one of the scientific theories of pain control – the “Gate Control Theory.”
It suggests that stimulation of tactile sensitivity receptors (touch sensation) blocks the “gates” in the spinal cord for pain signal transmission.
Simple Example:
- If you blow on a bruised area, the skin perceives the sensation of air, and the pain significantly decreases or disappears.
- This means that tactile signals can “override” pain impulses.
How Does the Neurostimulator Work?
If a special thin electrode is placed above the tactile sensitivity pathways of the spinal cord, stimulation with electrical current can induce tactile sensations (paresthesia) that “override” the pain.
There are also other scientific explanations for the mechanism of spinal cord stimulation.
The final stage of treatment is the implantation of a neurostimulator under the skin – an electrical impulse generator that delivers current with parameters selected by the physician.
16 reviews
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