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Remote approach to pain

Spinal implant gives relief to some with chronic back pain

Spinal implant gives relief to some with chronic back pain

August 27, 2007|By TIFFANY ARNOLD

It was another brisk walk through the cemetery for Bill Wolfinger, who this time last year was in too much pain for such a stroll.

Thanks to a spinal implant operated by remote control, Wolfinger is able to walk two to three miles at a time. Before he got the implant - a device about the size of an iPod - he wasn't able to do much walking at all.

"I wasn't really able to do anything other than just sit around. It was really awful," said Wolfinger, 62, of Hagerstown.

He walks through Rest Haven Cemetery every other day, "because it's quiet."

Wolfinger is among a growing number of chronic back pain sufferers who, after failed surgeries and back treatments, have sought out what is known as neurostimulation therapy, a procedure in which doctors implant a device into the lower back, said Dr. John Olenczak, an anesthesiologist and pain intervention specialist at the Pain and Spine Institute at Mid-Atlantic Orthopaedic Specialists in Hagerstown.

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The device blocks the sensation of pain by sending mild electric impulses through the spine. A cordless remote about the size of a pager allows patients to adjust treatment levels at a button's push.

At least three companies make the device, Olenczak said. One company, Medtronic, said its neurostimulation device has been used to treat roughly 200,000 chronic pain sufferers worldwide, according to its press material.

How it works

The thin, wiry leads are threaded through the spine and will deliver electric impulses that prevent pain signals from traveling to the brain. The result is a "tingling sensation" that replaces what otherwise would have been perceived as pain.

"Basically, it fools the brain into thinking the pain isn't there anymore," Olenczak said.

Most patients are "back to functioning" the day after surgery, Olenczak said.

There is very little scarring afterward; it's also difficult for outsiders to discern who has such a device. "If you're naked, you'll see a bump on your butt," said Kim Stouffer, a pain nurse at Mid-Atlantic Orthopaedic Specialists.

Neurostimulation therapy is not for everybody.

Olenczak said it's something usually considered after surgery and other forms of treatment have failed. Patients must also try an external trial stimulator and experience at least a 50 percent reduction in pain before receiving an implant.

The device is implanted permanently to prevent infection that could occur where the leads enter the body.

"You can't just say, 'My back hurts. I'd like to try this device,'" Olenczak said.

What it does for chronic back pain

Most patients who undergo the neurostimulation therapy see at least 50 percent reduction in pain and end up cutting back - if not discontinuing - their use of pain medication, Olenczak said.

Before the surgery, Wolfinger needed a cane or walker to walk and was on high doses of pain medication.

Wolfinger attributed his pain to his 33-year stint with the U.S. Air Force and his career as a cameraman, using his back to bear the brunt of heavy equipment.

"Seventeen years as a cameraman and bouncing around in an aircraft, it all caught up with me," Wolfinger said.

But things have changed since he got the surgery in June.

Wolfinger no longer uses pain medication and now walks two to three miles every other day - still not quite as far as the five to six miles he walked before he started having back problems.

He can no longer pick up a camera.

"It's not a cure-all," Wolfinger said. "You have to maintain a mindset that you can't do what you did before."

Ralph Whetsel, 72, who lives near Berkeley Springs, W.Va., said his back pain was "ungodly" before he had neurostimulation therapy in May.

Once, on a vacation, Whetsel said the pain was so bad he crawled out of bed and slept on a table in the hotel room. At home, he slept in an upright recliner. He couldn't stand to walk more than a block.

Whetsel attributed his back pain to slipping and falling in 2002, which was followed by several back surgeries and rounds of spinal injections.

Nothing seemed to take away the pain.

"It felt like someone took an ice pick and was swooshing down on your spine. Other times it was like someone had a knife and was twisting it around in your back," said Whetsel.

Then his primary doctor referred him to Olenczak.

"When they started talking about putting this wire through my spine, I was thinking, 'Is this real?' I had always heard you shouldn't mess around with the spine," Whetsel said. "It was kind of scary. But with all I had been through, I went for it. I had nothing to lose."

Now, Whetsel is able to do things that most people take for granted - like driving and sleeping in beds. Still, Whetsel might occasionally slip out of bed to snooze in the recliner.

"Because I'm used to it," he said.

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