Spinal Cord Stimulators-Plain Film

An adult with post by pass surgery X ray chest for evaluation  shows  spinal cord stimulator located possibly at  D-10  for effective sciatica management.

 Teaching points by Dr MGK Murthy.

·         Spinal cord stimulation for analgesia is used to exert pulsed electrode stimuli to   cord  to control chronic pain

·         Consists of    epidural  electrodes(number could vary from 4 to 12) (Wire or paddle variety)at one or multiple levels usually in epidural space and  connected via wires  to the generator  in lower abdomen, or gluteal space (for patient to manipulate)

·         Alters local neuro chemistry at dorsal horns  by decreasing the hyperexcitability  of neurons(possibly by increasing GABA and serotonin)(decreasing glutamate and  aspartate)

·         Radiology has role to identify the gadget ,  assist in correct positioning and  look for complications like leads mal positioned, detachment, breakage, and migration etc

·         Complications are  extremely unusual , however could range from local discomfort to transient paraplegia

·         Indications are usually Chronic  pain , like  Failed back syndrome, sciatica, malignancy etc