CRYSTAL CITY, Mo. – Spinal cord stimulation therapy has been providing pain relief for patients for decades, and the next breakthrough is in technololgy is taking place at Mercy Hospital Jefferson.
On October 7, Ramis Gheith, MD, medical director of the Interventional Pain Institute, implanted a new device to alleviate chronic pain. A fellowship trained and board certified anesthesiologist, Dr. Gheith is an expert in providing neuromodulation therapies to his patients. The company that created the new device chose his practice to launch this advanced therapy based on his expertise in his field.
“More important was the trial-to-success ratio,” Dr. Gheith said. “Correct patient selection is important. Once they researched our data, they chose our practice to launch their new product.”
Only select candidates are eligible for the procedure, but Dr. Gheith says there are many more patients who may get relief than you would expect.
“With over 200,000 spinal cord stimulators in use today, many patients are appropriate for this advanced pain therapy. In the United States, patients who are candidates for this therapy typically have chronic lower back or leg pain and have often undergone prior spinal surgery which failed to provide pain relief," Gheith said. “With more than 300,000 spinal surgeries each year and failure rates up to 40 percent. There is a huge population who could benefit.”
Chronic pain affects millions of Americans and costs the economy approximately 600 billion dollars annually when you take into account the cost of disability, lost work time, and dependence or abuse of narcotic pain medication.
“Conditions amenable to this therapy include failed back surgery syndrome, nerve pain from complex regional pain syndrome, shingles, and pain resulting from small fiber neuropathy, diabetes, infectious diseases, and medications used to treat cancer and HIV," Dr. Gheith said. “There are a lot of causes for chronic pain.”
The latest evolution in stimulation therapy gets its benefit from high frequency stimulation, unlike the traditional implantable devices that have provided pain relief for patients since the late 1960s. The technology uses mild electrical impulses delivered to the spinal cord and communicates with the brain to stop painful sensations.
“In traditional spinal cord stimulation it sends a pleasant tingling sensation to the brain to overcome pain signals,” Dr. Gheith said. “The new technology does the same thing but at a much higher frequency, about 10,000 hertz compared to 40 to 80 hertz. The impulse is not felt as a tingling sensation and patients were much more satisfied. The FDA analyzed the test data, and research found that patients had greater satisfaction, greater pain relief, better quality of life and achieved pain relief more quickly. It was found to be superior to the traditional system.”
Mercy Jefferson President Eric Ammons said the hospital is proud that Dr. Gheith chose Mercy Jefferson to provide this advanced technology. The surgeries are among the first in the country to utilize the system.
The device and its rechargeable battery system are implanted just below the skin through two small incisions, in the midline of the lower back and another just off to the side. The procedure is completed in the hospital operating room and takes about 45 minutes, he said.
“It is minimally invasive surgery, and with any surgery there is always some risk for infection or bleeding at the surgery site. The recovery time is about a week,” Dr Gheith said.
Like any medical device, it needs to be maintained. There is daily charging for the battery of 30 to 45 minutes.
“The battery could last forever, but the FDA requires us to replace it every seven years,” he said.
Patients try the new technology by using the spinal stimulation with an external battery pack. Only those who have the best potential for success are considered for the implantable device.
“We believe this new technology helps to reduce costs to the health care system and helps to find an answer to opioid medication misuse and abuse,” Dr. Gheith said.
Bringing in the newest technology and qualified providers is another example of Mercy fulfilling its promise for improved health care in our community.