Sciatica is usually caused by a herniated disc. Some patients show no response to medication, physiotherapy, or even surgery. Spinal cord stimulation is a ray of hope for them.
Spinal cord stimulation therapy is a very mature technology, with a history of forty years in Europe and the United States. However, there are only a handful of cases in Hong Kong.
This therapy is usually performed by a pain medicine specialist. Patients undergo a detailed examination and evaluation to determine whether they are suitable candidates. In addition to confirming that the patient has sciatica and that no other suitable method exists, the patient’s psychological state is also assessed. Furthermore, medical evidence shows that if the condition has lasted more than ten years, this therapy may not be effective.
Principle
Spinal cord stimulation therapy uses an implanted system to emit a weak electrical current that stimulates the spinal nerves, thereby controlling neuropathic pain.
The entire system consists of two main parts: the electrode lead and the nerve stimulator. The electrode lead is placed beside the spinal nerves in the lower back, while the nerve stimulator is usually placed under the skin in the abdomen or buttock area.
The patient can use an external remote control to adjust the intensity and mode of stimulation.
Before permanent implantation, the doctor first places a temporary electrode to test the effectiveness of this therapy.
Surgical Procedure
The surgery is usually carried out in two stages.
Stage 1: The doctor places a temporary electrode in the patient to test the position of the electrode and its effectiveness.
Stage 2: If the Stage 1 test proves effective, the doctor implants a permanent device in the patient. Depending on the model of the implanted device, the battery of this system typically needs to be replaced through a minor surgery after about five or ten years.
Other Indications
Besides being effective for sciatica, spinal cord stimulation can also be used to treat the following pain conditions:
- Complex Regional Pain Syndrome (CRPS)
- Severe angina
- Various types of neuropathic pain
- Pain caused by insufficient peripheral blood circulation
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- Information provided by Dr. Lee Yuk-ming, Specialist in Pain Medicine
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