Minimally Invasive Methods Used To Implant Epiducer™; “Pacemaker For Pain” May Help Many With Chronic Pain
ROCKVILLE CENTRE, NY – November 21, 2011 – A new device known as the Epiducer™ may help many patients with chronic pain, according to Brian J. Snyder, M.D., attending neurosurgeon, NSPC Brain & Spine Surgery (NSPC) Dr. Snyder is the first neurosurgeon on Long Island to implant the St. Jude Medical device in a recent procedure at Winthrop University Hospital. The Epiducer was cleared by the FDA in July 2011.
The epiducer is implanted using minimally invasive techniques, making it a better choice for some patients not willing to undergo a more invasive “open” surgery, or for those whom invasive surgery is not an option. A type of spinal cord stimulator, the device functions as a “pacemaker for pain,” delivering controlled electrical pulses that block the transmission of pain signals from the spinal cord to the brain. A number of spinal cord stimulators, known as “neurostimulation” devices, are currently on the market.
“Many patients with chronic pain who are not responsive to non-surgical treatment may benefit from this device, or from other types of neuromodulation,” says Dr. Snyder, who specializes in surgery for chronic pain, adult epilepsy, and movement disorders. “This is an important new treatment option.”
Neuromodulation therapies may be used when more conservative treatments for chronic pain do not provide relief. Types of pain treated by neuromodulation include pain of the torso, arms and legs, as well as pain from failed back surgery and from many other sources. Dr. Snyder uses a number of types of neuromodulation techniques and devices for chronic pain, including spinal cord stimulation, peripheral nerve stimulation, deep brain stimulation and implantable drug pumps.
Dr. Snyder says that the Epiducer was the best choice for this patient because she is younger, and had pain that radiated down only one leg. Dr. Snyder uses another minimally invasive device for some patients, while he uses more invasive surgery for others, depending on their age, type of pain, overall health and other factors.
All spinal cord stimulators consist of four components:
1. Neurostimulator or generator — a battery-operated device that is implanted, much like a cardiac pacemaker;
2. Lead – a thin wire with several electrodes or contacts that carry mild electrical pulses from the neurostimulator to targeted areas of the spinal cord;
3. Patient controller – a remote control device that the patient uses to turn the system on and off and select among preset pain-relief stimulation programs;
4. Programmer – a device that a doctor uses to set up the stimulation programs that run on the patient’s neurostimulator.
The Epiducer allows surgeons to place multiple large neurostimulation leads through a single entry point without invasive surgery and enables the surgeon to treat complex pain, such as low back pain combined with leg pain. Two other devices also offer pain relief, but they either require more extensive surgery or are minimally invasive, but provide less relief. One of these devices uses a smaller lead and allows for minimal incisions; however, because the lead is smaller, its placement does not deliver as much stimulation to the targeted nerves. A third type of device is placed through a larger incision directly over where the lead is placed, and requires going through muscle and removing bone (laminectomy).
“The Epiducer allows us to achieve more of the benefits of the laminectomy lead without as much surgery,” says Dr. Snyder.
While the more invasive procedure, or the other type of minimally invasive device, will still be appropriate for many patients, the new device may make spinal cord stimulation an option for some who were not previously good candidates for spinal cord stimulation.
According to the National Institutes of Health, 90 million Americans suffer from chronic pain. Chronic pain is generally defined as moderate to severe pain that lasts for six months or longer. Despite the availability of effective treatments, many people with chronic pain are undertreated and suffer needlessly for years.
Brian J. Snyder, M.D. is a neurosurgeon who specializes in treating chronic pain, seizure disorders and epilepsy, as well as movement disorders such as Parkinson’s disease, tremor and dystonia. He is a leading practitioner of deep brain stimulation (DBS), having trained under Dr. Andres Lozano, perhaps the world’s foremost DBS authority. He has extensive expertise in vagal nerve stimulation and procedures for mapping, recording and identifying seizure foci in the brain, and in the surgical resection of these foci. He is certified in both Gamma Knife® and CyberKnife® radiosurgery.