Think about spinal cord stimulation

Electrical stimulation: tingling instead of burning pain

Thanks to spinal cord stimulation (SCS) close to the spinal cord, the experts at the Department of Neurosurgery at the University Hospital Carl Gustav Carus Dresden can provide long-term help to selected patients with back pain and nerve pain - neuropathies. SCS systems have been implanted at the University Hospital since 1995. These stimulate certain nerve fibers along the spinal cord via electrodes and thus suppress the transmission of pain reports to the brain. This treatment method is tied to certain prerequisites and is only considered if no improvement can be achieved with other forms of therapy.

In electrostimulation close to the spinal cord, electrodes are implanted via a small operation that deliver electrical impulses of low voltage epidurally - via the hard meninges of the spinal cord - to the posterior cords of the spinal cord. In this way, abnormal sensations and pain that reach the brain via these nerve tracts can be suppressed. The experts at the Clinic for Neurosurgery have already been able to help many patients in this way. So does Sylvia Hesse. The now 50-year-old suffered a severe herniated disc more than 15 years ago. An operation could only relieve her pain for just under three years. The doctors did not get the severe pain under control afterwards, neither with further therapy nor with strong medication. The suffering was aggravated by changes in a vertebra. This additional source of pain could be switched off with a second operation, but afterwards scar tissue ensured that Sylvia Hesse continued to suffer.

"It was burning pain from the lower back to the toes," she remembers. Her life revolved around the fear of even stronger attacks of pain. Regular work as a geriatric nurse was out of the question. She only found out six years ago And the neurosurgeons at the university clinic quickly determined that the chances of success of this method were good for her. So Sylvia Hesse decided to have an operation where an electrode was implanted on her spinal cord through a small incision in her back Small, also implanted pulse generator. With a hand-held device, the patient can adjust the strength of the stimulation. The electrodes of the SCS send out electrical impulses of low intensity to stimulate certain nerve fibers along the spinal cord. This means that pain messages are no longer transmitted to the brain. Thanks to the electrical impulses, the patients feel ang More tingling or a sensation like a massage - the so-called paresthesia effect occurs.

"The pain is there, but it fades into the background," says Sylvia Hesse, describing the effect. The SCS shut off the pain in the head. A break for the 50-year-old: Today she hardly needs any medication, can do her housework as normal and look after her two adult children. Since the pain sensation in the morning is often less than in the evening, she does not need to leave the stimulator switched on all day. Nevertheless, the woman from Schöna, who lives in Bavaria today, feels the electrodes in her back. It is only limited by the fact that you should refrain from extreme sporting activity and avoid proximity to stronger electromagnetic fields - such as induction cookers. She also has to charge the implanted pulse generator every eight days. The fact that Sylvia Hesse came back to the Neurosurgery Clinic at the Dresden University Hospital after six years was due to the fact that the battery was exhausted. So the neurosurgeons implanted a new device under local anesthesia at the beginning of April.

An initial implantation of the SCS takes place in two steps: After the specialists have decided that a patient is suitable for the stimulation, they tested the spinal cord stimulation on him. To start with, only the electrodes are implanted. This is done under constant x-ray control in order to find the correct position of the electrodes. At the same time, tests are carried out to determine whether the electrical stimulation reaches the patient's painful areas. To do this, the neurosurgeons connect the electrode to an external stimulator during the procedure. In order to be able to place the electrodes optimally, the patient must be fully conscious. However, anesthetists are involved in this procedure so that the implantation is painless. After a successful test, the battery-powered stimulation device is connected to the electrodes that have already been inserted.

Contact
Carl Gustav Carus University Hospital
Neurosurgery Clinic
Director: Prof. Dr. med. Gabriele Schackert
Dr. med. Tareq Juratli
Dr. med. Amir Zolal
Tel .: 0351 458-18534
Email: NCH pain clinic
Internet: www.uniklinikum-dresden.de/nch