412 - Spinal Cord Stimulator

Spinal Cord Stimulator Kassandra Bahr, cst, csfa, dba APRIL 2018 | The Surgical Technologist | 157 L E A R N I N G O B J E C T I V E S s Learn about howmany people are affected by chronic pain s Identify the differences between pain as a result of an injury to that of someone who suffers from neuropathic pain s List the indications for SCS surgery s Examine the anatomy of the spinal cord in relation to this procedure s Discuss the surgical steps taken to implant a SCS B A C K G R O U N D T he neurosurgeonWillem Noordenbos reported that in the spinal cord, a signal carried along large diameter fibers for pressure, touch or vibration could potentially interrupt the signal sent by thinner pain fibers. Consequently, Melzak and Wall introduced the gate control theory of pain, which helps account for the importance of the mind in pain perception. The theory involves the complex nature and interaction of the nervous system, specifically the two major divisions: the peripheral nervous system (nerves outside spinal cord and brain, nerves in the extremities and torso, nerves in lumbar spine); and the central nervous system (spinal cord and brain). This theory helped pro- vide the framework for use and development of spinal cord stimulation (SCS) as a clinical and surgical treatment for chronic pain. From 1972- 1974, the first clinical trials of spinal cord stimulators were performed on patients who suffered from intractable chronic pain. Chronic pain is a misunderstood and largely under-treated disease that affects millions of people. Defined, chronic pain is moderate to severe pain lasting threemonths or longer. TheAmericanPainFoundationstates that chronic pain affects 76.5 million people. According to the National Institutes of Health, chronic pain impacts the US economy by $100 bil- lion in medical expenses and lost time at work. This article will discuss the use of spinal cord stimulators to treat chronic pain, detail the preop- erative patient preparation and identity the role of the Certified Surgical Technologist for this surgery.