Published on May 21, 2023
By JONATHAN S. DAITCH, MD Advanced Pain Management and Spine Specialist
spinal cord stimulator
Failed back surgery syndrome (FBSS) or post-laminectomy syndrome is a condition in which patients experience persistent pain after spinal surgery. However, this does not necessarily mean that the surgery failed.
In some cases, the pain may be caused by residual scar tissue around the nerve root, ongoing inflammation, or pain from an area that was not addressed by surgery.
It is estimated that the incidence of FBSS accounts for approximately 20% of back surgeries, while the success rate of lumbar spine reoperation is only approximately 20-30%.
Initial measures to treat pain may include oral medications, physical therapy, or spinal injections. However, if pain persists despite these measures, Spinal Cord Stimulation (SCS) Might be an option.
Spinal cord stimulation (SCS) involves placing nerve electrode wires (leads) into the epidural space behind the spinal cord. These wires carry a mild electrical current to the nerve fibers in the spinal cord. This, in turn, alters and reduces the pain signals reaching the brain, effectively eliminating the pain.
The beauty of SCS is that you can “try before you buy.” After the leads are placed, you will wear them for a week to see how effective this treatment is for you. During the week-long trial, leads are placed through the needle, secured in place, and then connected to the battery, which the patient carries with them for a week.
During the trial week, if the patient obtains 50% or greater pain relief from the device, it will be implanted. The leads are implanted under the skin in the mid-back, and the battery is usually implanted in the upper buttocks.
Older generations of SCS therapy involved the continued use of paresthesias (pins and needles) to achieve pain relief. In addition, previous batteries were larger and had shorter battery life.
Newer generations of spinal cord stimulators also use subperceptual stimulation. Advanced programming can now close pain pathways without the patient being aware of the stimulation, rather than relying on paresthesia (tingling) to cover the painful area. This is indeed the best solution.
These stimulators come in different forms, fixed Battery (lasts 3-7 years), rechargeable batteries, even No implanted battery If you prefer use a wearable antenna connected to an external battery.
Nathaniel is a successful example of this new type of spinal cord stimulation. In 2014, he was a passenger in a serious car accident that left him with severe pain in his lower back that radiated down his legs. Any activity made the pain worse, especially at night, seriously affecting his sleep.
Nathaniel underwent multiple surgeries, including fusion surgery, to find relief from the pain. However, as many patients discover, reoperation rarely leads to better results.
Determined to avoid further surgery, Nathaniel sought pain management. However, despite multiple injections and medications, he experienced minimal relief. He initially tried a spinal cord stimulator in 2016, but he simply didn’t like the feeling of paraesthesia.
Recently, further research led Nathaniel to Advanced Pain Management and Spine Specialists (Pain Relief Institute of America). After his initial appointment, he immediately felt confident about implanting this new SCS device, which could minimize or avoid paresthesia.
Although familiar with the surgical procedure, Nathaniel was impressed with the nursing team, especially the staff at Park Surgery Center. “This is by far the best professional team I’ve ever had,” he said.
Board-certified pain management physician Jonathan S. Daitch, MD, explains that SCS surgery requires only two incisions of less than 2 inches and allows for a quick recovery. “Within 2 weeks of having the SCS implanted, I was walking with very little pain,” Nathaniel said. He was able to bend over, sit, lie down, and even sleep with minimal discomfort, all feats after years of debilitating pain.
Advanced options for pain management, through correct diagnosis and appropriate treatment, can resolve or minimize pain without relying on pain medications.
To discuss chronic pain that has “failed” treatment elsewhere, or to pursue options other than surgery, please call Advanced Pain Management & Specialists: 352-397-4930.
