Implantable Devices

Implantable devices for back pain are devices that are surgically implanted in the body to either block or compete with pain signals travelling to the brain. Pain management devices include pain pumps which deliver medication directly to the spine, neurostimulators (spinal cord stimulators) which deliver pulses of electrical energy to the epidural space near your spine. The pain pumps involve much smaller doses of medications than oral medications because they arrive directly at the area of the spine that that is transmitting the pain signals. This lowered dose of medication eliminates many of the harmful complications and side effects that occur with steroidal and non-steroidal anti-inflammatory medications that affect the body in a systemic way. The smaller dose of medications also enables patients to receive significant pain relief without the need for narcotic pain medications which are associated with many harmful side effects, such as kidney disease and dependence.

Electrical stimulators also give patients the clinical benefit of pain relief without the harmful side effects that medications cause.

Both of these types of treatments may offer patients the type of pain relief that other treatments weren't able to provide, including back surgery.

Let's take a closer at the individual types of implantable devices, what types of medicine they deliver, and what clinical benefits they have over other forms of back pain treatments.

Spinal cord Stimulators: Spinal cord stimulators may be used to successfully treat neuropathy in cases where other treatments have failed to provide patients with relief. Typically, we experience pain when pain signals travel from the peripheral nervous system in our body, to the spinal cord and brain of the central nervous system. If the transmission of the pain signal is blocked at any point from its origin, the end result will be that we won't experience pain. These devices transmit energy from a power source to the dorsal portion of the spinal cord to inhibit pain signals from travelling any further than this level of the spine. Pain signals are inhibited from travelling any higher than this level of the spine.



The stimulators deliver pulses of energy at particular energy levels at particular intervals of time. The sensors (wires) may be threaded through the body, to the dorsal portion of the spinal cord, from a power source (battery) implanted permanently inside the body. Or the wires may be threaded through the body from a power source that is located outside the body. The power source may be implanted from outside the body in a less invasive trial period of this device in which the doctors continuously adjust the settings until a good therapeutic dose can be determined. This gives doctors and patients a chance to adjust the settings on the device to see if one of the settings offers clinical benefits - in terms of pain relief and comfort. This also gives patients the chance to experience the potential benefits of this type of treatment without having to commit to surgery right away. If the external trial period manages to provide clinical benefits, and the patient reports that he or she wants to go ahead to use the spinal cord stimulator as a long-term treatment, then it may be implanted surgically in the body. The device is surgically implanted under the skin, in either the upper buttocks or abdomen.

Spinal cord stimulators may provide significant relief from back conditions such as sciatica and failed back surgery syndrome. This device has proven to have long-term benefits for a majority of patients that have used them. Many patients continue reporting pain relief for up to 20 years after the original implantation of the device. Between 50-60% of patients who have experimented with these types of devices have reported significant pain relief.

Spinal Pumps: Spinal pumps are also referred to as pain pumps, drug pumps, and Intrathecal drug delivery systems. These devices deliver narcotic pain medication, directly into the intrathecal space around the spinal cord. This treatment keeps the amount of narcotic medication that the patient takes out of the patient's control, so that complications such as dependence and addiction don't occur. These systems also involve the delivery of much smaller amounts of medication, so that complications that affect whole body systems, such as GI bleeding and altered kidney functioning don't occur. The delivery of the narcotic medication, usually morphine, is designed to only act on that part of the body.

The spinal pump itself is implanted inside the body in a surgical procedure. This pump can be programmed to deliver a certain amount of medication in certain intervals of time. This pump may be refilled with medication without having to perform another operation to gain access to the pump device. The pump is refilled by injecting the medication through the skin into the pump reservoir.

Spinal pumps may be used to treat a variety of chronic pain conditions, including painful spasticity associated with multiple sclerosis, axial somatic pain, and pain from osteoporosis.