The pain pacemaker is a system that prevents the patient from feeling pain by stimulating a very thin electrode placed behind the spinal cord. It is especially applied to patients with chronic pain who have had surgery but whose pain persists. It can also be applied to patients who have pain in the legs after spinal cord injury.
Is it possible to eliminate the pain completely or does it only reduce the severity of the pain?
The pain is completely eliminated in some patients, while reduced in some patients. The goal is to reduce pain by at least 50% with a pain pacemaker.
How is the pain pacemaker integrated into the body?
Pain pacemaker can be applied in two ways.
The first method is to place the electrode on the spinal cord by entering the gap between the spine, which we call epidural distance, with the help of a very fine needle with local anesthesia. It is a short process and the patient does not feel much pain during the process. The advantages of this process are that there is no need for general anesthesia, that the pain area is fully covered by talking to the patient momentarily and thus providing the best pain relief. It is generally not possible to apply to patients who have operated on their back like scoliosis patients. It can be applied to patients who have undergone surgery at lower levels at the waist. The second method is entering through a small cut under general anesthesia and to place the electrode directly on the spinal cord by an operation. In both methods, the other ends of the placed electrodes are taken out of the body and connected to the test pacemaker. The test pacemaker period usually lasts several weeks. If the patient is satisfied during the test pacemaker period, a permanent pacemaker is placed under the skin with a small operation.
How is the pain pacemaker used?
Two types of pacemakers can be implanted into the patient. Normal pacemaker or rechargeable pacemaker. If a rechargeable pacemaker is implanted, it is necessary to charge the pacemaker from the outside with the wireless system at regular intervals. The normal pacemaker lasts for 4-5 years, while rechargeable pacemakers last for 8-9 years, although it varies from patient to patient. When the pacemaker reaches the end of its life, it is replaced with a new pacemaker.
Can a pain pacemaker be implanted as an initial treatment for someone who has never undergone surgery? What are the criteria?
Pain pacemaker is a method used as a last resort in patients with pain. For this reason, it is not appropriate to insert to a herniated disc patient who has never undergone surgery. The most important application criterion is pain caused by the nerve’s own damage called neuropathic pain. Patients who have undergone low back surgery, who do not have postoperative nerve compression, but whose pain persists, are suitable for the pain pacemaker. If the patient has a low back problem that can be recovered by surgery, it is not appropriate to insert a pain pacemaker. First, surgical treatment should be tried. If there is no benefit for the patient with surgery, firstly drug therapy, physical therapy and, if necessary, algological attempts called epidural injection should be tried. If no treatment method works, then pain pacemaker treatment may be decided.
Does the use of a pain pacemaker discontinue drug use?
Patients who are candidates for pain pacemaker are usually those who have been living with painkillers for a long time. Continuous use of painkillers can damage our body. The main goal of implantation of a pain pacemaker is to reduce the patient’s drug dependence or, if possible, to stop it completely.
Can patients choose the pain pacemaker by trial method? If they’re not satisfied, do they have a chance to remove the pain pacemaker?
A testing pacemaker is implanted first to the patients who are found suitable for the pain pacemaker. During the trial period, only the electrode is present in the patient’s body. The testing pacemaker is outside of the body. The electrodes are easily removed if there is not enough decrease in the patient’s pain during the pacemaker testing period or if the patient is not satisfied with the process. If the patient feels discomfort and is not satisfied with the permanent pacemaker, the system can be completely removed under local anesthesia with a short procedure.
Are the practices successful in Turkey? Are there case examples? How is the interest in Turkey? Do patients know the “pain pacemaker”?
Practices in Turkey are quite successful. It is a very pleasing moment for both the patient and the physician to see that patients’ pain have gone away and their faces have been smiling after the application of the pain pacemaker for the patients who have been in pain for a long time and who have tried all treatment methods. The most important criterion for success is that the patient and doctor struggle with the pain together. In our country, patients know the pain pacemaker, but it is important to raise the awareness of the public about pain pacemaker.
How is the use in the world?
It is a widely used method in the world. It is used especially in the United States and the European Union within the framework of certain rules as used in our country.