Orthopedics in the News: The Risks of Spinal Cord Stimulators
The Wall Street Journal recently covered a Duke University study that examined the FDA’s database of adverse events resulting from spinal cord stimulators in 12,300 patients. The study related the number of complications to the number of implants, and showed a rate of 1 per 100. This is a significantly higher rate of orthopedics paralysis and weakness than was previously thought to be caused by these devices. A previous study submitted by stimulator manufacturers (Medtronic, Boston Scientific and St. Jude Medical) showed a rate of only 3.8 complications per 1,000 implants.
Spinal cord stimulators are devices that produce a low voltage electrical signal that is thought to disrupt the pain pathway between the spine and the brain. Pain is simply an electrical signal processed by the brain, and the stimulator functions to alters that signal. The electrical alteration of the pain signal causes the brain to ‘feel’ less pain. Unfortunately, this orthopedic device is invasively placed inside the spinal canal by way of a dissection through skin, muscle and ligaments and has been shown to damage the spinal cord. Sometimes placing this device can cause paralysis.
Spinal cord stimulators are placed by a variety of doctors in order to treat chronic pain, which is pain that has lasted more than 3 months and has failed all other treatment.
Pain is complicated and there are many non-surgical techniques available to treat it. A spinal cord stimulator should not be implanted without considering every other possible option. There are many brain techniques controlled by the patients themselves that are available to alter the pain signals, such as cognitive behavioral therapy. This particular technique has a better success rate than spinal cord stimulators, with no risk of paralysis. Some people with chronic pain may suffer from problems with how their brain processes pain, and so should receive a psychological evaluation before being considered for orthopedic surgery such as implanting a spinal cord stimulator. Often, pain may be reduced significantly with alternative techniques that are not presented to the patient. Once the pain is reduced by these techniques and treatments, a dangerous stimulator is not necessary.
Pain can be affected by everything from diet, to the air one breathes, from emotions and stress levels. One effective treatment that is cost-effective and within the control of the patients themselves is yoga. The medical industry does not typically present yoga to an individual as a treatment option. Yoga has been shown to be extremely safe and highly effective for the relief of chronic pain. Manual physical rehabilitation is another effective and safe treatment for chonic pain. Proper manual physical therapy with a highly trained therapist, licensed in this discipline, works well to treat chronic pain. Another method of treating chonic pain that is often not presented to a patient is nutrition. Dietary changes and supplements such as vitamin D3 and Omega 3 have also been shown to affect pain processing in the brain and nerve function. Correcting deficiencies in one’s nutrition often decreases pain and increases function.
Most back pain actually comes from the muscles that support and move the spine and may be easily treated with simple orthopedic techniques targeting the skeletal muscle itself. Although most people have a ‘disc’ in their back, most discs do not cause pain. However, discs are often used to rationalize expensive and dangerous treatments. Spinal cord stimulators can cost $60,000 for the device alone. If there is a devastating complication like paralysis from the insertion of a stimulator, the costs skyrocket further.
The risk of spinal cord stimulator implants becomes untenable when one considers the many other options that are totally safe and available for the treatment of chronic pain.
Image courtesy of Praisaeng / FreeDigitalPhotos.net
Dr. Meredith Warner is a board certified, Fellowship Trained Foot and Ankle, Orthopedic surgeon practicing in Baton Rouge, Louisiana. Dr. Warner is committed to offering her patients an accurate diagnosis along with a comprehensive treatment plan in order to get them back to a pain free life. Dr. Meredith Warner specializes in the treatment of orthopedic issues, providing operative and non-operative treatment plans of orthopedic problems, including musculoskeletal pain such as chronic back, neck and foot pain, reconstructive surgery of the foot and ankle, arthritis, diabetic, hammer toe, bunion, wound care, work injuries, fitness and nutrition and osteoporosis issues.