Spinal Cord Stimulation for Chronic Pain

The nervous system is a communication network between the brain and all body parts. Nerve signals are continuously transmitted from the body to the brain to alert a person to problems and thus prevent injury. However, if nerves are damaged, they may send false pain signals to the brain even in the absence of injury. Dr. Zeiad Yossry, Professor of Neurosurgery and Parkinson's Disease, stimulates the spinal cord to disrupt these faulty signals.

A person may experience persistent pain related to muscle or joint injuries, arthritis, compressed nerves, uncontrolled diabetes, medical procedures, or other conditions. Chronic pain continues even after the original cause has resolved. Spinal cord stimulation is especially effective in nerve-related pain.

Under normal circumstances, pain is a protective process; it alerts you when you're hurt. However, pain isn't always protective. Many conditions cause extremely severe pain, or pain that doesn't subside or go away. This can make it difficult to sleep or work. Over time, living with chronic pain can have serious consequences, causing changes in your brain and nervous system. These changes may increase the intensity of pain (hyperalgesia) or cause your nervous system to send pain signals to things that shouldn't hurt (allodynia). In some cases, your nervous system may send random or persistent pain signals.

Chronic pain lasts longer than expected, leading to fatigue, low energy, difficulty sleeping, mood swings, and difficulty working or even performing normal daily activities. Therefore, prompt medical intervention is recommended when the pain does not improve with rest.

Spinal cord stimulation (SCS) therapy disrupts pain signals that travel between the spinal cord and the brain, providing effective pain relief.

In this interventional pain treatment technique, Dr. Zeiad Yossry, Professor of Neurosurgery and Parkinson's Disease, implants a permanent spinal cord stimulator under the skin. This stimulator sends regular electrical pulses to an area near the spine, specifically to the pain-causing spinal nerves, blocking the transmission of pain signals from reaching the brain. The implanted device is small, similar to a pacemaker, and does not interfere with normal daily activities. Spinal cord stimulation therapy helps reduce dependence on oral painkillers, and encourages patients to return to their favorite daily activities.

Spinal cord stimulation treats chronic, severe pain when other pain control methods fail, including:

• Failed back surgery syndrome (FBSS).

• Complex regional pain syndrome (CRPS).

• Chronic lower back pain that does not respond to other treatments.

• Chronic arm and leg pain.

A temporary external pulse generator is connected to test the effectiveness of spinal cord stimulation before moving to permanent implantation.

1. The patient lies face down.

2. The skin is sterilized, and he is given a local anesthetic to numb the injection area.

3. Dr. Zeiad Yossry inserts the wires through a needle under the skin and into the spinal cord near the targeted spinal nerves.

4. Dr. Zeiad Yossry then connects these wires to a small external pulse generator, carried by the patient during the trial period.

5. The patient is monitored in the recovery room under the healthcare team’s supervision.

If pain improves by at least 50% during the trial period, the patient will undergo a second procedure to implant a permanent spinal cord stimulator under the skin for long-term pain management.

1. The patient lies face down, and the skin at the surgical site is sterilized.

2. The patient is given general anesthesia.

3.  Dr. Zeiad Yossry connects the wires to a smaller permanent stimulator, which is implanted under the skin.

4.  Dr. Zeiad Yossry places the device at waist level, on the side that is most easily accessible, usually on the side opposite the patient’s preferred sleeping side (decided in advance).

5. The stimulator is controlled by a small handheld controller, allowing adjustments as needed.

• Long-term treatment for chronic pain that is resistant to other therapies; therefore, spinal cord stimulation is mainly used as an alternative when other methods are not effective.

• Improvement of the ability to work.

• More effective than repeated surgeries for treating pain.

• Reduction of the patient's dependence on strong painkillers known for their side effects and potential risks, as spinal cord stimulation lowers pain levels, allowing patients to reduce dosage, frequency, or both.

Thin electrodes are placed near the spinal cord, and the neurostimulator device is permanently implanted under the skin. The stimulation consists of very mild electrical pulses that you usually cannot feel. These pulses mask pain signals. The procedure typically takes around three hours, and recovery takes a few weeks.

Your neurostimulation system will not be activated until after you have recovered, so you won’t feel immediate relief after surgery. Once Dr. Zeiad Yossry activates the system, you'll work together to find the right stimulation level for you. You'll have follow-up appointments approximately every six months.

After the initial recovery period, SCS becomes a regular part of your daily life. 

• It usually does not show through clothing.

• You may feel it as a bump under the skin.

• It can be adjusted using a handheld therapy controller.

Spinal cord stimulation with Dr. Zeiad Yossry, Professor of Neurosurgery and Parkinson's Disease, is an effective and safe option for those suffering from chronic pain that doesn't respond to conventional treatments. It provides long-term relief, improves your ability to function, and reduces your reliance on strong painkillers. Thanks to medical advances, it's now possible to regain daily activities with greater comfort and confidence.