A dorsal spinal cord stimulator is a device for chronic pain control. The stimulator comprises an electrode connected to a battery-powered generator surgically implanted in the back near the spinal cord. An electric signal is sent to the spinal cord to decrease the sensation of pain by replacing it with a mild tingling sensation.

In the first stage of this procedure, a stimulation lead is placed while the patient is under local anesthesia in the operating room. After the placement of the lead is confirmed by X-ray, it is connected to an external stimulator and tested. When the level of stimulation is reached that will control the pain, the lead is sutured into place. One end of the lead comes out through the skin. When the patient is in the recovery room, the lead will be connected to the external stimulator. Patients are taught how to use the stimulator, and most patients go home the same day.

If the patient is satisfied with the level of stimulation after one or two weeks, an implantable stimulator is placed in a pocket made on the abdominal wall underneath the skin. This procedure is usually done under general anesthesia. The stimulating lead is tunneled under the skin and connected to this stimulator.

Both procedures take about one hour.

Common Questions About Dorsal Spinal Cord Stimulation

Will the procedure hurt?

The procedure involves inserting a needle through the skin and deeper tissues. There is some discomfort, but the skin and deeper tissues are numbed with a local anesthetic using a thin needle. Most patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate.

How long does the stimulator last?

Depending on how much the device is used (intensity and duration), the batteries usually last 10 years. The batteries cannot be replaced or recharged.

Will I be "put out" for this procedure?

The placement of the wires is done under local anesthesia with patients mildly sedated. The amount of sedation given depends on the patient's tolerance.

Where are the wires inserted? Where is the generator placed?

For lower-back and lower-extremities pain, the wires are inserted in the midline at the lower back. The generator is then placed on the side of the back or upper hip.

What should I expect after the procedure?

If the procedure is successful, you may think your pain is gone or less. You will feel a constant sensation of stimulation. You may have soreness for a couple of days because of the needles used.

What should I do after the procedure?

Patients normally go home the day of the procedure. Some patients may be kept overnight for observation. You should have someone with you to take you home. We advise you to rest for a day or so after the procedure. Perform activities as tolerated.

Will the stimulator help me?

It is difficult to predict if the procedure will help. For that reason, temporary wires are placed to determine whether this device will be effective in relieving your pain. Typically, patients will have a 50 percent to 70 percent reduction in pain.

What are the risks and side effects?

This procedure is safe but there are risks, side effects and potential complications. The complications include:

• Bleeding
• Infection
• Nerve injury
• Generator malfunction
• Lead disconnection