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Spinal Cord Stimulation: A Three-Phase Fight Against Chronic Pain


Submitted by: Mississippi Valley Surgery Center

Nearly one in five people worldwide suffer from moderate to severe chronic pain. It strikes individuals differently and sometimes builds gradually.

Before you know it, weeks turn to months, and you’re forced miss out on the things that brought you joy—shutting out friends and family, missing time with your kids, struggling with day-to-day activities—all because of chronic pain.

Dr. Maruti Kari, with UnityPoint Pain Center, is getting individuals back to the lives they love at Mississippi Valley Surgery Center.

“A lot of people don’t realize the stigma towards patients with chronic pain,” said Dr. Kari. “Most of these people are just trying to live a normal life, but the world is closing down on them. I’ve seen families falling apart when they walk through our door, but I’ve also seen lives changed with this technique that can decrease pain by more than 50 percent.”

As an expert in the latest advancements in chronic pain management, Dr. Kari often recommends spinal cord stimulation when nonsurgical pain treatment options have failed to provide enough relief.

Spinal cord stimulation: a leading-edge technology option
Everyone experiences some aches and pains, but chronic pain is different than typical pain. Nerve signals in the body are constantly sending messages to the brain—when a nerve is injured, it can continue to send pain signals to your brain even after an injury is healed. This is when chronic pain persists. Spinal cord stimulators can be used to disrupt and mask the pain signals that are traveling to the brain.

Most of Dr. Kari’s spinal cord stimulation procedures are completed at Mississippi Valley Surgery Center. Since opening its doors in 1996 as the first outpatient center in the area, MVSC has set the standard for excellence. With a medical staff focused on individualized patient care, they’re experts in the latest, proven techniques that lead to better outcomes and faster recovery.

“Spinal cord stimulation can be a truly effective way to curb chronic pain,” Dr. Kari said. “While it doesn’t rid the body of what’s causing the pain, it changes the way the brain perceives it.”

Spinal cord stimulation technology has advanced within the last four years so that it can stimulate more specific areas of the body. For example, instead of stimulating the entire leg, the stimulators can now be pinpointed to stimulate only the foot.

Not only does a spinal cord stimulation rid the body of pain in a relatively short amount of time, but it does so in a way that reduces the need for pain medications.

“With so many opioid deaths and overdoses, medication is not something many physicians want to employ,” Dr. Kari said. “And if a patient who has been taking narcotic pain medication comes into my office, it’s clear that the medication isn’t working. Spinal cord stimulation is a good alternative.”

Phase one: a psychological assessment
When a patient is considered a good candidate for a spinal cord stimulator, they begin a three-phase process with Dr. Kari. If the patient is using insurance to pay for the surgery, their process requires an evaluation by a board-certified psychologist to evaluate the likelihood of successful outcomes.

During the assessment, the psychologist evaluates the medical history, chronic pain struggles and coping skills of the patient. Understanding the full picture of the patient, including mental health, and even the patient’s support system, is an important part of procedure success.

“It is important for us to know the lifestyle of the patient, and the coping mechanisms they’ve used to mitigate pain up until this point,” Dr. Kari said. “If their lifestyle and how they manage the pain is unhealthy, no matter how well the device works, they could continue to have pain.”

Phase two: putting the device to the test
Once a patient is approved by a psychologist, phase two begins. Known as the spinal cord stimulator trial phase, phase two allows patients to test the device without getting it permanently implanted. In fact, the spinal cord stimulator is the only device that patients can try first without getting implanted.

When undergoing the trial procedure at MVSC, the patient receives a local anesthetic to numb the area. Insulated wires, called leads, are carefully placed through a needle and connected to a small stimulator that remains on the outside of the body. Daily phone calls are made to the patient from Dr. Kari and his team to monitor the stimulation over a seven-day period, and the leads are easily removed at the end of the trial.

While some physicians recommend taking time off work during the trial period, Dr. Kari recommends that they remain in their usual routines.

“This device is supposed to help you in your normal, everyday life,” he said. “If the patient sits in a chair all day, their pain may decrease. To me, that defeats the purpose. I want to make sure the patient can return back to their everyday life.”

Once the seven-day trial period is over, Dr. Kari meets with the patient to discuss how they’re feeling.

“If a patient comes back after the trial period and tells me it was pure magic, that’s when we put the device in permanently. If the patient comes back and tells me, ‘Hmm, I think it helped some, but I’m not sure,’ then we don’t put it in. I don’t want my patients to have a permanent device if they’re not 100 percent convinced that it’s something that’s good for them.”

Phase three: permanent implant, permanent results
For nearly 90 percent of patients who do find success during the trial period, it’s then time to move to phase three—permanent implantation. During this time, the leads are placed underneath the skin through a small incision in the back and the spinal cord stimulator is implanted in the abdominal or buttocks area. The patient can increase and decrease the level of stimulation using a remote or Bluetooth app, reducing their pain by 50 to 70 percent.

While this is considered a minor surgical procedure, it can safely be done in an outpatient setting—like MVSC—allowing many patients to recover at home within hours of surgery and return to light levels of activity within days.

“I encourage everyone to think about their quality of life and consider if pain has made a negative impact,” Dr. Kari said. “If you’re not able to do the things you used to enjoy, that’s when you should definitely consider taking action.”

If you’re interested in learning if spinal cord stimulation would be a good fit for you, work with your primary care doctor to get a referral to Dr. Kari with UnityPoint Pain Center. To learn more about Mississippi Valley Surgery Center, go to www.mvhealth.net or visit the center’s Facebook page at facebook.com/MississippiValleySurgeryCenter.