Dorsal cord stimulators, more commonly known as spinal cord stimulators, are electronic devices that are implanted and serve to treat chronic pain. They do not cure pain but instead work to lower it. This should result in a higher level of activity and a decreased need for pain medication. Like all surgical interventions, it comes with its own set of risks that must be weighed by patients before undergoing treatment
Increased Pain
Increased pain especially localized around the surgical site should be expected for up to 2 weeks after surgery, usually from the incision and resulting tissue inflammation.
Infection
Infection is a risk in all surgical procedures; in the case of spinal cord stimulators, these usually occur at the incision site, spinal cord or occasionally the vertebrae.
Pneumothorax
This is defined as lung collapse and occurs when needles inserted into the chest or upper back penetrate the lung.
Nerve Damage
Electrodes that are part of the stimulator and needles can directly damage nerves. Bleeding can result in collections of blood called hematomas that can also squeeze nerves or the spinal cord itself. Paralysis, altered sensation and loss of bowel and bladder function can occur. In some cases, emergency surgery may be required that may or may not be able to fix the damage.
Headache
This is caused by leakage of spinal fluid out of the epidural space where it normally is found. This commonly occurs around the electrode wire site.
Allergic Reactions
These can occur due to medications such as anesthetics or contrast dyes used during surgery and can often be quite dangerous.
Seroma Collection
Fluid collections, such as blood from excess bleeding, around the surgical site are known as seroma. It must be drained by the surgeon due to the risk of the fluid collection becoming a focus of infection.
Device Problems
Like all machines, the device can malfunction; this most commonly entails something called percutaneous lead migration. This is when the leads move and the stimulation no longer has effect over the body region responsible for symptoms. This will usually result in revisional surgery to fix the problem.
References
- "Essentials of Physical Medicine and Rehabilitation, 2nd Ed;" Frontera; 2008
- eOrthopod: Spinal Cord Stimulators
