Neurostimulation in Denver

If you're living with chronic pain, the board-certified neurosurgeons within the HealthONE Physician Group network are here to help you live your best life. Through the use of neuromodulation, our physicians will work hard to get you the relief you deserve so you can do the things you love the most.

For more information on our neuromodulation serivces, please schedule an appointment.

What is neuromodulation?

Neuromodulation is a medical approach that alters the nervous system to treat diseases and injuries and their symptoms. While one form treats patients using medications, neurostimulation is the surgical application that involves placing electrodes on the spinal cord or peripheral nerves.

When you experience chronic pain or other neurological conditions, your brain could be sending abnormal electrical signals to your nervous system. By strategically sending impulses to various parts of your nervous system, we can try to correct these abnormal electrical signals and hopefully decrease your pain.

The most common targets are the spinal cord or the small nerves located under the skin. Other areas of the nervous system can also be stimulated, such as the brain or the nerve roots. With spinal stimulators, the electrodes are placed onto the protective membrane of the spinal cord through an incision. To access the spinal canal, doctors must remove a small amount of bone as well.

Neurostimulation of the nerves involves placing electrodes on the peripheral nerves via surgical exposure or needle placement. For this surgical procedure, the wires from the electrode are then tunneled under the skin to the implantable pulse generator (IPG), where they are attached.

The IPG contains the battery and the circuitry that sends signals to the electrode. The circuitry is programmed to send signals that maximize the effect of the electrodes.

Who benefits from neurostimulation?

If you have been seeking relief from chronic pain and other treatments have failed, a neurostimulator might be right for you. A neurostimulator — sometimes informally called a "brain pacemaker" — can help:

  • Patients with pain that lasts longer than six months
  • Patients experiencing long-lasting post-surgical pain
  • Patients who have tried other therapies that did not work or produced unwanted side effects

Conditions we treat with neurostimulation

Neuromodulation therapy can be used in the treatment of a range of conditions and pain that is intractable — meaning you have not found an effective treatment. Some conditions we treat include:

  • Abdominal pain
  • Back pain
  • Complex regional pain syndrome
  • Foot pain
  • Intractable angina
  • Intractable headaches and migraines
  • Neck pain
  • Pain from peripheral vascular disease
  • Pelvic pain
  • Phantom limb pain or stump pain
  • Reflex sympathetic dystrophy
  • Urinary incontinence

Neurostimulation trials

Many people experience meaningful pain relief through neurostimulation. However, before you commit to a permanent neurostimulator, you start with a trial period consisting of seven to 10 days of stimulation. During your trial, you record notes to see if the stimulation is effective. After the trial, if you are satisfied with the results, we make a plan for permanent implantation.

Types of stimulation trials

There are two ways a stimulation trial can be conducted. One is with temporary percutaneous leads, and the other is with paddle leads. Both approaches have their upsides and downsides, but our experts can help you decide which trial type is right for you.

Paddle leads

A paddle lead trial is performed in two surgical stages separated by about one week. In the first stage, the paddle leads are placed surgically and then attached to a temporary extension cable that is brought through the skin. This procedure usually requires an overnight hospital stay. The stimulation is then tested for one week during which you track pain levels, the amount of pain medicine you take, and activity level.

One week later, you'll meet with our neurosurgical team to assess the results of the trial. If the trial is successful in reducing or eliminating your pain, we implant a permanent pulse generator to connect to the paddle leads. If the trial is unsuccessful, we'll remove the paddle leads, and nothing is implanted. The second surgery typically takes place the next day and is an outpatient procedure.

Percutaneous leads

A trial with percutaneous leads — leads implanted through the skin — is a minimally invasive outpatient procedure performed under conscious sedation. Temporary stimulator wires are placed in the body through the skin and guided to areas that provide you with relief. Once the stimulator wire is taped in place, you go to the recovery room while the sedation is wearing off.

In the recovery room, the stimulator will be programmed to give you the best overall pain relief. You wear the stimulator for seven to 10 days, all the while tracking pain, medication and activity level.

If during that time you decide it had a positive effect on any of those parameters, then you are scheduled for permanent implantation of an electrode and an implantable pulse generator.