Spinal Cord Stimulator Implant (Neuromodulation) for Chronic Pelvic Pain

Spinal cord stimulation (SCS) is a unique, innovative treatment option used to relief pain related to many conditions. A spinal cord stimulator implant can be used for chronic pelvic pain. Also called neuromodulation, SCS has been proven to improve quality of life, reduce pain, and improve blood flow to the affected body region.

How does spinal cord stimulation work?

A spinal cord stimulator works with a portion of the spinal cord known as the dorsal column. The unit uses technology similar to a pacemaker. The stimulator sends signals to the brain via the spinal cord, which interfere with pain signal transmission. Electrical signals are sent via the stimulator to the spinal cord. This creates a pleasant sensation that blocks pain perception.

How long does the spinal cord stimulator trial take?

The doctor will have you use a modified form of the spinal cord stimulator for 4-7 days before permanently implanting the device. The procedure involves placement of tiny electrodes along the spinal cord via a specialized needle and wires that run from the leads to the generator, which is outside the body.

Is the neuromodulator implant right for me?

Spinal cord stimulation is used for people who:

• Have chronic persistent pain.
• Do not respond to other treatment modalities.
• Are not reliant on pain medications.
• Respond to the trial stimulator procedure.

How are the electrical current impulses controlled?

After the stimulator is implanted, you will be given a remote the size of a cell phone. This device turns the stimulator on and off, sets the intensity of electrical current, and works much like a remote control. The remote can easily fit in your pocket or purse.

How will I know if the spinal cord stimulator works?

A successful SCS trial is where the patient reports greater than 50% pain relief. In addition, a successful trial involves noticeable decrease in pain medicine use and increased function in daily activities.

What can I expect during the permanent implant procedure?

If the neuromodulation trial is effective, the doctor will schedule you for a permanent stimulator implant. After a nurse places an IV catheter in your arm, you will be given antibiotics to reduce infection and general anesthesia. The skin over the back is cleaned, and a small incision is made so the doctor can see the spaces between the vertebrae where leads are inserted.

A small needle is used to place the leads into the epidural space, which is near the spinal cord. Fluoroscopy (real-time x-ray) is used for lead placement. An incision is made on the abdomen or buttocks so the stimulator can be placed. After placement, wires run from the tiny unit to attach to the electrodes near the spinal cord.

Is the SCS procedure effective for treating pelvic pain?

According to a case-series report, several patients reported significant pain relief using spinal cord stimulation. All patients reported more than 50% reduction of pain, and opiate use decreased from 22.5 mg to 6.6 mg of morphine milligram equivalents per day.

Resources

Kapural L, Narouze SN, Janicki TI, & Mekhail N (2006). Spinal cord stimulation is an effective treatment for the chronic intractable visceral pelvic pain. Pain Med, 7(5), 440-443.