Neurostimulation is a treatment that delivers electrical impulses through an electrode implanted in the epidural space, near the spinal cord.
An implanted neurostimulator consists of an electrode in the epidural space connected to a fully internal battery placed under the skin of the abdomen. The electrode sends soft electrical impulses to the SNC. The electrical impulses activate the pain-inhibiting neurons located in the dorsal horn of the spinal cord and thereby reduce the perception of pain.
The objective of the electrical impulses sent is that they mask the pain signals received, and a slight tingling is perceived.
The external device allows adjusting the intensity and location of these tingling so that it is possible to perform daily activities.
It is implanted with local anesthesia, and the doctor adjusts the neurostimulation externally with the programmer, and the patient can open and close the device, as well as increase or decrease its intensity.
Indications of Epidural Neurostimulation
- CRPS (distrofia simpático refleja)
- Intercostal neuralgia
- Chronic neuropathies
Postlaminectomy syndrome (failed surgery)
- Ghost member
- Postherpetic neuralgia
Criteria for the use of Epidural Neurostimulation
- Moderate or severe pain for more than 6 months
- Neuropathic features (tingling, punctures, numbness, itching, burning …)
- No improvement with other treatments, or because of their intolerance to them
- They have no indication of surgical intervention
- They have no contraindications for the implant
The placement is percutaneous, through a needle electrocatheter is introduced, into the epidural space and according to the area we want to stimulate.
Although at the end of the electrode insertion, a test is done intraoperatively, and it can be modified before the end of the procedure.
Image that visualizes the catheter implanted in the epidural space, through which electrical impulses are emitted to different areas of pain.
In the example below, we see an electrode placed on the 3rd bilateral occipital nerve, in a patient who presented a lesion of the same secondary to trauma.