Treatment Options

Spinal Cord Stimulator

A spinal cord stimulator is an electronic device that is implanted in the body to help relieve chronic pain. Also known as a dorsal column stimulator, the device sends low electrical currents through wires placed near the spinal cord to treat pain. It allows patients to control when pain relief is needed or not.

The device does not cure chronic pain, but usually provides a 50% or greater decrease in pain and allows patients to be more active and have less of a need for pain medication. This procedure is usually considered when other solutions, such as surgery, injections and medications, have failed. Before implantation, patients will often be asked to go through a trial period with an external device. The trial will test patients' pain levels and see if they increase with the help of the device.

During the implantation of the permanent device, wires are fed with a needle and positioned on the spinal cord. The actual device is placed dependent on where the pain is. The device can be removed if necessary. The battery of the device must be replaced every 2 to 5 years. Complications rarely occur as the procedure is very safe and minimally invasive. Proper care following the procedure is required and includes limiting movement and avoiding driving for the first few weeks.

Radiofrequency Rhizotomy

Radiofrequency rhizotomy is a procedure that can be an effective form of treatment for chronically painful conditions such as trigeminal neuralgia that have not responded well to medication. Trigeminal neuralgia causes severe, shooting pain in the face due to damage to or compression of the trigeminal nerve. Radiofrequency rhizotomy involves using radiofrequency energy to stop the nerve from sending pain signals.

This outpatient procedure generally lasts between one and two hours and begins with the patient being given a short-acting anesthesia. The doctor inserts a needle into the nerve and uses an imaging device to ensure that it is properly positioned. The patient is then awakened to determine the precise portion of the nerve that is the source of the pain. Once that is established, the patient is sedated again and the radiofrequency energy is sent through the needle to destroy a small segment of the nerve.

A common side effect of radiofrequency rhizotomy is numbness in an area of the face. This is often temporary, but in some cases it is permanent. Other potential complications include recurring pain, loss of vision, muscle weakness and brain injury. Choosing an experienced surgeon to perform a radiofrequency rhizotomy can lower a patient's risk of developing complications.

Discography

A discography, also known as a discogram, is a diagnostic test performed to determine whether back pain is a result of certain spinal disc abnormalities.

The intervertebral discs are spongy pads of cartilage that offer cushioning and allow for flexibility between the vertebrae of the spine. A herniated disc, also called a ruptured or slipped disc, is a common condition that may occur as a result of gradual wear and tear on the disc or from an injury to the spine that cracks or tears the disc and causes it to bulge or break open. This can produce pain, numbness and weakness in the back or legs as the disc presses on the nearby nerve roots. It is important to determine which disc or discs are damaged in order to ensure that the patient will receive the appropriate form of treatment.

A discography test is performed by injecting a special dye into the patient's spinal discs and using imaging technology to view the area in greater detail. Due to its invasive nature, a discography is only considered for patients with persistent back pain that remains unresponsive to treatment. A discography may also be performed on candidates for spinal fusion surgery to identify the damaged discs that will need to be removed during surgery.

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