The Neuromodulation Service co-ordinates the implantation of Spinal Cord Stimulators and Intrathecal Medication Pumps. These are advanced medical treatments used to manage severe chronic pain. They are used only on select patients who meet specific criteria and after all conservative methods of treatment have been explored and exhausted. The Pain Centre is only one of three centres in British Columbia to offer these treatments.

The Spinal Cord Stimulator

The Spinal Cord Stimulator (referred to as SCS) has been used for about 30 years but only recently has come into increased use. The SCS has been offered at The Pain Centre since 1999.

Spinal Cord Stimulation is the stimulation of selected nerves by tiny electrical pulses. A lead is implanted in the fatty layer of tissue, the epidural space, surrounding the spinal cord. The lead is inserted through a small incision in the back, and positioned near the nerves that supply the area that is painful. The lead is connected to a battery system, which is implanted in the abdominal area beneath the skin. The Spinal Cord Stimulator sends electrical impulses to the nervous system that partially block pain messages to the brain.

The Spinal Cord Stimulator does not cure the underlying cause of the pain, but rather replaces some of the pain with a sensation described by some patients as “tingling”. The sensation and the percentage of pain reduction vary from patient to patient. A Spinal Cord Stimulator will not mask sharp pain from a new injury. Programming of the stimulator is conducted at the time of the implant, and as necessary on an outpatient basis with the Neuromodulation Nurse.

Spinal Cord Stimulation is a reversible procedure that does not damage the spinal cord or the nerves.

The Intrathecal Medication Pump

The Intrathecal Medication Pump is an internal drug delivery system. The system consists of a pump and a catheter (a very thin flexible tube), both of which are surgically placed under the skin. The pump reservoir is implanted under the skin in the abdominal area. A thin flexible catheter is implanted in the space around the spinal cord and above the painful area in the body requiring medication. The catheter is then tunneled under the skin and connected to the pump. The pump reservoir is filled with medication, which is dispensed on a continuous basis. Depending on the patient’s needs, the pump is refilled every one to three months on an outpatient basis.

Benefits

Benefits of the Spinal Cord Stimulator and Intrathecal Pump could include:

• improved pain relief
• increased activity levels
• reduced use of narcotics, other types of medications and their side effects
• reduced hospitalizations and surgical procedures
• reduced health care costs i.e. hospitalizations, physician visits
• greater independence and improved quality of life
• enhanced return to work potential

To maximize the effectiveness of these procedures, a strong commitment is required from the patient to actively participate in their pain management program. These procedures are just one piece of the patient’s pain management program.