treating chronic pain

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Assessment of spinal cord stimulator in treatment of chronic pain

News-Medical.net

Published: Monday, 7-Jun-2004

A neurosurgeon at the University of Illinois at Chicago is assessing how

well an implanted electronic device that stimulates nerve fibers in the

spinal cord relieves chronic pain.

The device, made by Advanced Neuromodulation Systems, is already

approved by the Food and Drug Administration, but is undergoing further

evaluation at several sites throughout the United States for potential

marketing overseas.

" Coping with chronic pain is one of life's greatest challenges, " said

Dr. Konstantin Slavin, assistant professor of neurosurgery at the UIC

College of Medicine.

More than 50 million Americans suffer from chronic pain, Slavin said,

and many of them become partially or totally disabled. " That's why it is

important to identify effective methods for treating intractable pain,

and document the extent to which these treatments can improve patients'

quality of life. "

Functioning like a cardiac pacemaker, which uses electrical impulses to

regulate the heartbeat, the Genesis Implantable Pulse Generator

transmits low-level electrical impulses to the spinal cord to modify

pain signals. The electrical impulses alter messages before they reach

the brain, replacing the pain signals with what patients describe as a

tingling sensation.

The system, which is used to treat chronic pain in the trunk or limbs,

consists of a pulse generator and leads. It is implanted during a

surgical procedure that can be brief and minimally invasive, depending

on the type of leads emplaced.

The leads are positioned in the space above the spinal cord, called the

epidural space, with electrodes at the end of the leads in contact with

the specific nerve fibers extending from the spinal cord that are the

source of the patient's pain.

The pulse generator is the power source, consisting of a battery and

related electronics housed in a single metal container that is about the

size of a silver dollar. It is placed just under the skin in a practical

location determined by the physician and patient, usually on the abdomen

or just below the beltline on the back.

Patients use an external device -- a remote control -- to turn the

stimulator on and off. They can increase or decrease the pulse

transmitted to the nerve fibers to match their current activity or pain

level.

Spinal cord stimulation is not a cure, so it doesn't usually eliminate

all sensations of pain, but it can lessen the intensity of the pain,

Slavin said, decreasing the need for medication and allowing patients to

resume more normal activities.

The device can be used around the clock, if necessary, or only as needed

during the day or night.

A total of 15 patients will be involved in the study at UIC, with up to

50 patients enrolled at five sites nationwide. Before the pulse

generator is implanted and again one month, three months and six months

after the surgery, participants will be asked to fill out a

questionnaire that reviews medical history, pain symptoms and

characteristics, pain location and quality of life.

Patients interested in obtaining more information about the study may

call (800) 597-5970 and ask for the research division.

http://uillinoismedcenter.org