Spinal Cord Stimulator – A boon for patients
with pains of Neuropathic origin
Spinal Cord Stimulation is a therapy that masks
pain signals before they reach the brain. A small
device called the Spinal Cord Stimulator is
implanted in the body for the same.
How It Works: Spinal Cord Stimulation
is based on the gate control theory of pain
proposed by Wall and Melzack. Pain is
felt because nerves send the pain signal to
the brain. This pain transmission occurs
through the ‘gate’ in substantia gelatinosa
in the dorsal aspect of the spinal cord. At
the gate, both myelinated fibre (which
transmits pressure, touch and vibration)
and unmyelinated fibres (which transmits
pain) try to pass messages through the
synapse. However, through the gate,
only one message can pass through at a
time; either through myelinated fibres
or unmyelinated fibres. The message
through myelinated fibres is preferred over
unmyelinated ones.
Spinal Cord Stimulator is a small
device implanted inside the body (like a
pacemaker), which has a pulse generator
with a battery and thin wires called ‘leads”.
It is operated through an external handheld
remote control. When the patient
feels pain, he presses the remote, electrical
pulses are generated which are carried by
leads to the spinal cord that blocks the pain
signals through the ‘gate’ travelling to the
brain. Instead of pain, the patient feels a
vibration/fluttering sensation that replaces
the pain. Stimulation does not eliminate the
source of pain, it simply interferes with the
signal to the brain, and so the amount of
pain relief varies for each person.
Indications: Spinal Cord Stimulation is particularly effective for relieving the pain of neuropathic origin. The most common indications include –
Dr. Puneet Girdhar
Director – Spine Surgery
BLK Centre for Orthopaedics,
Joint Reconstruction
& Spine Surgery
BLK Super Speciality
Hospital, New Delhi
Dr. Rohit Gulati
Consultant –
Pain Management
BLK Super Speciality
Hospital, New Delhi