Contact and Hours:

1580 Valencia Street Suite 703
San Francisco, CA 94110
Phone: 415-642-0707
Fax: 415-648-7988

Monday through Thursday:
7:30 am to 4:30 pm

Friday 8:00 am to 3:00 pm

Closed Saturday and

Spinal Cord Stimulators

This device delivers small electrical pulses to the spinal cord thereby changing the pain signals reaching your brain.
Before proceeding with the actual implant, a series of steps will have to be taken. First, you will need to be evaluated by a Medical Psychologist with experience in chronic pain management. Assuming that your psychological profile does not contraindicate the implant therapy, you will then have to undergo an "
outpatient trial". This trial is design to find out if you get any benefit from the treatment before committing to the permanent implant.
How Is The Trial Conducted?
The trial is done in an out-patient basis. You will have a temporary leads placed under light sedation with the assistance of an x-ray machine. You will then go home with the leads in place for the next 5 to 7 days. The only restriction is essentially not showering since the lead are connected to the spine. Ideally, you should try to perform normal activities to see if the therapy is beneficial.

What Is The Purpose Of The Trial?
Provide the patient with the best possible results, by identifying any possible problems, early. The trial is similar to a "Test Drive" prior to purchasing a car. It allows you to see how it feels, before you commit to it.

Stimulator What Do You Look For In A Trial?
We look for two things. The first is to see if the stimulation will be effective in providing you with the desired relief of the pain. The second is to find out if you will be able to tolerate the stimulation well without experiencing any side effects.
What Possible Problems Could We Encounter During The Trial?
Just like any other medical procedure, it has its risks and possible complication. Some of these may include bleeding, infection, nerve damage and death. These are rare, but need to be mentioned because they are always possible. The more common side effects are: soreness at the trial site, itching, and rash.

If the trial is deemed a success, then a permanent implant can be considered.

Will The Procedure Hurt?
The procedure involves inserting a long needle through skin and deeper tissues (like a "tetanus shot") to the epidural space. So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle first. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate.

Will I Be "Put Out" For This Procedure?
No, the placement of the stimulator and leads are done under local anesthesia and intravenous sedation. The amount of sedation given generally depends upon the patient tolerance. The procedure is divided in two stages. The first stage (lead placement) is done with the local anesthesia and sedation, for safety purposes. At the beginning of this stage, the patients will experience a stick and the sting from the local anesthetic. This is the most uncomfortable part of the procedure. Once the leads are in place, the anesthesia is deepened and the stimulator (battery) can be implanted.
How Is The Procedure Performed?
It is done with the patient lying on their stomach. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. The skin is cleaned with antiseptic solution and then the procedure is carried out. X-ray (fluoroscopy) is used to guide the needle for inserting the leads.

Where Are The Lead Inserted? Where Is The Stimulator Placed?
Leads are inserted in the midline at the lower back. The stimulator is then placed either on the right or left area of your back below the belt line.

What Should I Expect After The Procedure?
If the procedure is successful, you may feel that your pain may be controlled or quite less. The stimulator is adjusted electronically to deliver adequate amount of stimulation over your painful areas. As with any other surgical procedure, it will take 8-10 weeks for the wound to heal to the point where the skin strength is back to normal.

What Should I Do After The Procedure?
This procedure is normally an outpatient procedure. After a one to two hour recovery period, you will be allowed to go home. You must have a responsible, strong adult drive you home. This person should be able to assist you in moving if you are still weak from the anesthetics. You should plan to rest for the remainder of the week. You will need to take antibiotics to prevent infection.

How Long Will The Stimulator Last?
Most stimulators now have chargeable batteries. These are charged through the skin so no new incisions are necessary. The frequency of charging depends on your individual needs. Current stimulator batteries will last approximately ten years of recharge cycles. Then the battery will need to be changed surgically.