Neuromodulation and SCS

One of the challenges of treatment of chronic pain using either medications or interventional procedures is the fact that neither are permanent fix which means, for medications, patients have to carry on taking them, if they are effective, on daily basis and for interventions, probably they might need to be repeated in the near or far future.

The ideal treatment then seems to be one that would live with patients for life sorting out their pain symptoms and working on the pain transmission pathways and this is how the concept of neuromodulation using spinal cord stimulators came to practice.

Spinal cord stimulators are among the most advanced, fast growing, intelligent treatment options, that benefit from the fast growth in technology, for long standing pain conditions especially those due to abnormal firing of nerves or the so-called neuropathic pain conditions, be it after surgery such as persistent leg pain and back pain after back surgery or secondary to conditions such as diabetes related painful diabetic neuropathy or conditions such as post herpetic neuralgia or CRPS.

Dr Alkholany is delighted to be able to offer this treatment to his patients after he had focused training on the procedure at a prestigious institute in the UK, Guy’s and St Thomas’ Hospital in London.

The treatment goes by stages where the patient is assessed first for suitability to undergo the treatment followed by a trial phase where through an epidural technique, leads are fed in the epidural space onto specific anatomic areas where traffic of pain transmission is high. Those leads are connected to an external small controlling unit to stimulate or modulate those anatomic areas and consequently pain transimission, and the patient is followed up for few days to couple of weeks afterwards to see if their symptoms would respond to the treatment.

If the trial is successful, the patient would undergo a minor surgical procedure involving 2 small surgical incisions in the back, where fresh leads are inserted and tunnelled under the skin to be connected to an internal controlling unit called IPG (Implantable Pulse Generator) which in essence is like a small computer similar to pacemaker and the patient would have the whole system as their friend for life.

The patient could feel the stimulation as a slight tingly feeling but also the system could be programmed to deliver tingling free stimulation that the patient can’t perceive yet is equally effective.

The beauty of this treatment is the fact that patients can live as close to normal life as possible on daily basis with their symptoms under control without the need to worry about medications or interventional procedures.

All the interventions related to this treatment happen as day case under sedation which means patients can go home after the procedure and have their recovery at home in a familiar environment.