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Title: Initial Experience With Spinal Cord Stimulation For Pain: Technicalities, Challenges And Outcomes
e-poster Number: INSIM71
Category: Pain
Author Name: Sanjeev Srivastava
Institute: Artemis Hospital
Co-Author Name: Dr Aditya Gupta
Abstract :
Aim: To assess our initial experience with spinal cord stimulation (SCS) for chronic refractory neuropathic pain as regards to its technicalities, challenges faced and assessment of outcomes
Material and methods: Between December 2018 to July 2019, 2 patients were assessed for refractory back pain and underwent SCS procedure, first one for a CRPS (Chronic regional pain syndrome) and another for a failed back. The procedure protocol included a 'Trial' with lead electrodes placed staggered on the dorsal cord epidurally and on-table intraoperative stimulation with an external pulse generator(EPG) with the patient being awake under local anesthesia. Postoperatively, both the patients underwent stimulation (for about a week) on different settings until a satisfactory and sustained pain relief was achieved with an EPG. Once the patients were convinced with the benefits obtained with stimulation, the "Permanent' procedure was done with lead electrodes being connected to an Internal Pulse generator(IPG) under general anesthesia.
Results: Both patients did significantly well on their pain scores (more than 50% change in VAS) and were quite satisfied with the procedure however were concerned about repeated neuromodualtion if required in their native places.
Conclusion: SCS is an established procedure of pain relief for refractory pain syndromes. It is technically not difficult but requires team work with a Neurosurgeon, pain physician, company technician and a physiotherapist. Patient cooperation during the 'trail', repeated assessments and neuromodulation for pain relief is required albeit initially. The cost of implants and availability of a company representatives in different regions is also a challenge.
