Tuesday, April 9, 2013
New procedure gives spinal pain patients hope
In an instant, Rachel Fannin's life would be dramatically altered.
Just before she became a teenager, Rachel was cleaning an aquarium at her home when she pressed down on one side with her left foot. She didn't expect to break through. And she couldn't foresee how the shards of glass and the subsequent infection would lead to chronic nerve injury and pain in her foot and leg.
By the start of 2013, in her 16th year, Rachel, had gone through 50 surgeries as a result of the complications from the accident. But the 51st surgery, which was performed at Trident Medical Center in North Charleston, would finally bring her reliable relief for her leg pain, allowing her to return to her favorite activities, while also breaking new medical ground.
In fact, Rachel was the first person in the country to have a Precision Spectra Spinal Cord Stimulator implanted for pain relief. "It's probably the biggest advance in this technology in about eight to 10 years," says neurosurgeon Dr. Jason Highsmith, who performed the implant surgery for Rachel as well as another patient on Jan. 9.
Spinal cord stimulation (SCS) has been used for chronic pain for four decades. Yet the latest generation of this therapy, the Precision Spectra SCS System by Boston Scientific, offers even more hope for adults with chronic intractable pain of the legs and low back. Dr. Highsmith is one of only 10 surgeons in the country trained to implant the new system at this time.
Here's how spinal cord stimulation works: A pulse generator with advanced electronics and a rechargeable battery is implanted along with insulated wires, called leads. Normally, the electrical signals that communicate pain travel along the spinal cord to the brain. The pulse generator masks those pain signals by sending different electrical impulses that are perceived by the brain as a smooth, light tingling sensation. Externally, the patient can easily control the pain therapy with a wireless remote control.
The Precision Spectra SCS system provides more coverage of the spinal cord than any other system before it by offering four lead ports and up to 32 contacts with 32 unique power sources. (A contact is an area on a lead that can provide stimulation to the patient.) Until now, other systems only provided 16 contacts. Dr. Highsmith says other aspects of spinal cord stimulation have been improved, too, for example, the sensation that masks the pain is more pleasant. "It feels like it's massaging my muscles," Rachel explains.
The minimally invasive procedure can be done on an outpatient basis. Rachel was able to return to her home in Florence County the same day, and within a few weeks, she was planning trips to go horseback riding and to the beach. In the past, she had to restrict her activity, and it was painful to let anything touch her leg, including sheets and clothing, so she usually wore shorts. "Now I can do and wear whatever I want."
Dr. Highsmith is excited at the possibilities for pain relief that the new system promises, but says that patients first need to work with a pain specialist and try other measures before resorting to surgery, which is his specialty.
"It's probably the biggest advance in this technology in about eight to 10 years." neurosurgeon Dr. Jason Highsmith, Trident Medical Center