Neuromodulation Definition

Definition

Spinal cord stimulation system components.
Spinal cord stimulation system components.. Getty Images News/Getty Images North America/ Getty Images

Neuromodulation Definition

Neuromodulation is a treatment that delivers either electricity or drugs to nerves in order to change their activity. Neuromodulation is the name for an overall category of treatment, one that can be used for a variety of diseases and symptoms, under which there are two types of treatments.

Neuromodulation is used to treat a wide range of ailments.  A partial list includes spinal cord damage, headaches, Parkinson's disease, angina, chronic back pain, other types of chronic pain conditions such as complex regional pain syndrome, and even deafness.

Studies are being done on other conditions, as well.

Is Neuromodulation Safe and Effective?

Neuromodulation is regarded as a safe treatment, mainly because installing the equipment and monitoring it is a minimally invasive procedure, according to the Neuromodulation Appropriateness Consensus Committee in their August 2014 guideline.  (The guideline was published in the journal Neuromodulation.)

This is good because most patients who turn to this type of pain management have already been through conservative medical treatment with little or no luck. One potential problem though, is device-related complications.  But the Committee reports that incidences of such issues are becoming less frequent, as technology advances and doctors' skills with neuromodulation continue to improve.

The Committee also reported that medical studies do support the effectiveness of neuromodulation for failed back surgery syndrome (FBSS.)

In 2012, Rigoard, et. al., studied 11 failed back surgery patients who had spinal cord stimulators implanted for pain relief.  The researchers wanted to see if newer type spinal cord stimulator leads, which were multi-column, tripolar, would completely relieve the patients’ back pain. They concluded that, indeed, neurostimulators are able to reliably generate coverage and good outcomes in terms of relief for chronic back pain patients.

Types of Neuromodulation

  • Neurostimulation: delivers electrical signals to the brain, spinal cord or nerves.  Word on the street (internet forums and social media groups) is that many people find relieve with this route with few complications. Also, as noted above, studies show that favorable results can be had from this type of neuromodulation
  • Implanted drug pumps: sometimes used as a last resort in pain management therapy for people with severe chronic back pain syndromes.  One big advantage of drug pumps is that the medication is delivered directly to the area that needs it, which allows for much lower doses.

Sources:

Deer TR, Mekhail N, Provenzano D, Pope J, Krames E, Leong M, Levy RM, Abejon D, Buchser E, Burton A, Buvanendran A, Candido K, Caraway D, Cousins M, DeJongste M, Diwan S, Eldabe S, Gatzinsky K, Foreman RD, Hayek S, Kim P, Kinfe T, Kloth D, Kumar K, Rizvi S, Lad SP, Liem L, Linderoth B, Mackey S, McDowell G, McRoberts P, Poree L, Prager J, Raso L, Rauck R, Russo M, Simpson B, Slavin K, Staats P, Stanton-Hicks M, Verrills P, Wellington J, Williams K, North R; Neuromodulation Appropriateness Consensus Committee. The appropriate use of neurostimulation of the spinal cord and peripheral nervous system for the treatment of chronic pain and ischemic diseases: the Neuromodulation Appropriateness Consensus Committee. Neuromodulation. 2014 Aug;17(6):515-50; discussion 550. doi: 10.1111/ner.12208.

Rigoard P1, Delmotte A, D'Houtaud S, Misbert L, Diallo B, Roy-Moreau A, Durand S, Royoux S, Giot JP, Bataille B. Back pain: a real target for spinal cord stimulation? Neurosurgery. 2012 Mar;70(3):574-84; discussion 584-5. doi: 10.1227/NEU.0b013e318236a57c.

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