medtronic dorsal column stimulator implant

3 This difference is likely related, at least in part, to a lack of awareness about spinal cord stimulation and high upfront device costs ($20 000–$30 000). Usage of spinal cord stimulators has increased worldwide, and according to the United States Food and Drug Administration, an estimated 50 000 devices are implanted annually in the US (150 cases/million population However, uptake in Canada has been substantially lower, with 172 implantations performed in Ontario in 2018 (12 cases/million population). 2 The technology has since advanced, and it was a Canadian neurosurgeon who helped demonstrate both the efficacy and cost-effectiveness of spinal cord stimulation in chronic pain treatment. 2, 3, 5 It is based on the principle of electrically stimulating the dorsal column of the spinal cord, to mask pain signals. Neuromodulation, defined as the alteration of nerve activity through targeted stimulus delivery, was first introduced in 1967. When conventional therapies produce unacceptable adverse effects or do not provide sufficient pain relief, spinal cord stimulation (neuromodulation) may offer a rescue option, either alone or in conjunction with other modalities.

1, 2 Consequently, alternatives - including cognitive behavioural therapy, physical rehabilitation, non-opiate pharmacology and integrative therapies - have been developed.

1 Although opioids have been the mainstay of treatment, they have lost favourability owing to crises of addiction, abuse, tolerance and dependence. Increased awareness of and access to spinal cord stimulation therapy may allow more Canadians to benefit from relief of intractable chronic pain and may reduce opioid consumption.Ĭhronic pain affects 1 in 5 Canadians and is associated with considerable socioeconomic burden.

Newer spinal cord stimulation technologies are expanding clinical indications such as visceral and ischemic pain, with potential for further improved efficacy. Spinal cord stimulation is safe, efficacious and cost-effective in chronic pain management of neuropathic pain conditions, including failed back surgery syndrome, chronic regional pain syndrome and chronic peripheral neuropathies. Spinal cord stimulation masks pain signals through a transcutaneous implantable electric pulse generator.

Medtronic dorsal column stimulator implant