Failed back surgery syndrome (FBSS) is the name given to back pain that persists despite surgical intervention. It’s technically a misnomer, though, as it is not a syndrome but rather a generalized term used to refer to the condition of patients whose pain did not respond well to spinal surgery.
If you’ve been diagnosed with failed back surgery syndrome, you know firsthand the frustration of expecting relief after surgery and finding none. The good news is that you still have options. Recent improvements in medical technology have made spinal cord stimulation a fast and effective way to relieve persistent back, neck, and leg pain.
What follows is an overview of the different types of spinal cord stimulation as well as answers to some frequently asked questions about the procedure. By researching your condition, you can make an informed decision about your treatment and approach your recovery with more confidence.
Types of Stimulation and How They Compare
In order to understand how spinal cord stimulator treatment works, it’s helpful to understand the basic anatomy of the nervous system. The nervous system consists of your brain, your spinal cord and all of the nerves around your body. Nerves send signals to the brain and spinal cord using electrical pulses, and medical researchers discovered that if they disrupted these electrical pulses, they could interrupt the transmission of pain signals. After years of testing and refining the procedure, spinal cord stimulation for back pain was approved by the Food and Drug Administration in 1989.
During a spinal cord stimulator procedure, your surgeon will place an electrode within your spinal canal and connect the electrode to a generator. The generator will then send electrical stimulation through the electrode and into your spinal nerves, which will interrupt pain signaling and relieve your discomfort.
While the general protocol for spinal cord stimulation remains the same from patient to patient, the particular type of electrical stimulation used may vary. There are two types of spinal cord stimulation currently in use, and you should carefully consider the differences between them before making your decision.
Tonic Spinal Cord Stimulation
Tonic spinal cord stimulation, also known as low-frequency spinal cord stimulation, is the most common form of this treatment. While many patients’ symptoms improve with tonic spinal cord stimulation, it comes with a side effect known as stimulation paresthesia. Stimulation paresthesia refers to the tingling and buzzing that many patients report while their spinal cord stimulator is active. Although stimulation paresthesia usually masks the back pain, some patients find the sensation unpleasant.
High-frequency Spinal Cord Stimulation
Unlike low-frequency spinal cord stimulation, high-frequency spinal cord stimulation does not cause stimulation paresthesias. The high frequencies used are effective at relieving the sensation of back pain without causing any tingling and buzzing. This type of spinal cord stimulation is generally more effective than the low-frequency variant, but it depends on the patient. To learn more about which type of spinal cord stimulator you should use, talk with your surgeon.
FAQs
Why has no one ever recommended spinal cord stimulation to me before?
This is a difficult question because there are many possible answers. The likely reason, however, is that many physicians and patients are simply unaware of this therapy and its effectiveness in treating back pain. Spinal cord stimulation technology has been improving rapidly in recent years, and it can take time for new therapies to catch on and spread in popularity.
How big is the device used for spinal cord stimulation?
The stimulators used are about as small as cardiac pacemakers (roughly the size of a 50-cent coin with 5 times the thickness), and patients generally report no issues with the size of spinal cord stimulators. Your surgeon can provide more details regarding the size of the particular spinal cord stimulator he or she uses, as the size can vary amongst the different types available.
Will a spinal cord stimulator make airport screenings complicated?
No. After your operation, you will need to carry a special card that shows airport security that you have a spinal cord stimulator. The card is similar to any other form of identification, and you will have no trouble passing through security with it. Talk with your surgeon to learn how to obtain it.
How long will I be in the hospital for the spinal cord stimulator procedure?
Spinal cord stimulator procedures are typically performed on an outpatient basis. The length of your hospital stay will depend on the details of your condition, but the likely case is that you will be free to go home after two or three hours.
What happens during the procedure?
For tonic spinal cord stimulation, the procedure is similar to an epidural injection. You will be under mild sedation and your surgeon will use an X-ray machine to guide the electrodes into your spine. Then, your surgeon will turn the device on and ask for your feedback to make sure that they are in the optimal position to cover your pain. Once the electrodes are in the right location, a dressing will be applied and you will be taken to a recovery room.
For high frequency spinal cord stimulation, the procedure is the same, except that you do not need to be awake. You will be awakened after the procedure is completed and then taken to the recovery room.
Why Is This Important?
Failed back syndrome can be a frustrating and painful condition, but it’s important to understand that you have options beyond conventional spinal surgery. Reading articles about spinal cord stimulator treatment is a good way to inform yourself so that you can have productive discussions with your surgeon about your path forward.
