Spinal Cord Stimulator Implant for Failed Neck Surgery Syndrome
Failed neck surgery syndrome is the term used to describe pain and other symptoms that begins or persists following a cervical (neck) spine procedure. This condition can be seriously debilitating. Doctors have found that failed neck surgery syndrome responds to spinal cord stimulation (SCS).
How common is failed neck surgery syndrome?
According to statistics, around 450 cases of herniated disc per 100,000 require spine surgery. The incidence of failed neck surgery syndrome is lower than the lumbar spine, but still exceeds 10%. Failed lumbar spine surgery occurs in up to an astounding 40% of cases!
What causes failed neck surgery syndrome?
The cause of continued pain after neck surgery depends on the type of surgery performed, the patient’s symptoms, and the actual cause of neck pain. Issues that lead to failed neck surgery syndrome include existence of multiple pain sources, complications during surgery, problems during the rehabilitation process, and misdiagnosis before the procedure.
What is a spinal cord stimulator implant?
A spinal cord stimulator is a small device that delivers tiny electrical currents to the spinal cord. Also called neurostimulation, SCS delivers impulses that prevent the brain from receiving chronic pain signals. The implant is placed in the lower abdomen or buttock, and wires run from the device to small leads placed along the spine.
What is a spinal cord stimulator trial?
The doctor will recommend a 5-7 day trial of spinal cord implant. This involves placing leads along the spine and running wires to a device outside the body. The leads are placed along the spine in an outpatient procedure. If the trial goes well, you may undergo the surgery for permanent placement of a spinal cord stimulator implant.
How do I prepare for the procedure?
Before surgery, you should not eat or drink after midnight. Be sure to arrange to have someone drive you home. Also, discuss your medications with the doctor during your consultation. Certain blood thinning agents must be held for several days. When you arrive at the surgical center, a nurse will discuss the procedure risks and benefits, and have you sign a form of informed consent. After you change into a procedure gown, an IV catheter is placed in your arm.
How is the procedure performed?
After you are given general anesthesia, the doctor makes a small incision over the spine to insert the leads. The leads are placed through needles using x-ray guidance. Another incision is made on the skin of the abdomen or buttock. The generator is placed, and wires extend from the unit to the leads. When the generator is turned on, you are awakened so as to can notify the doctor if you sense paresthesia (buzzing and tingling). After the correct intensity is determined, the incisions are closed using sutures, and bandages are applied.
What can I expect after the procedure?
After a spinal cord stimulator implant procedure, you will have soreness at the incision sites. Expect some mild bleeding and bruising also. You are not allowed to drive for a few days, and cannot participate in rigorous activities for around 2 months. Be sure to discuss your activity restrictions with the doctor.
Does SCS work?
Around 70% of all patients who have a spinal cord stimulator implant report a reduction in overall pain.
Resources
MD Guidelines. Post-laminectomy syndrome. Retrieved from: http://www.mdguidelines.com/post-laminectomy-syndrome
Kumar K, Nath R, & Toth C (1997). Spinal cord stimulation is effective in the management of reflex sympathetic dystrophy. Neurosurgery 40: 503-509.