At times, the percutaneous electrode does not give satisfactory broad enough stimulation and this percutaneous electrode is removed and replaced with a flat electrode measuring approximately x 3 inches. This electrode is inserted through a mini-laminotomy under local anesthesia with test stimulation for accurate placement. However, more discrete and accurate changes in stimulation parameters may be programmed externally through the patient's skin by way of a radiotelemetry console programmer controlled by the physician. Patients with predominately lower extremity pain usually achieve the best results from spinal cord stimulation. It is apparent that spinal cord stimulation is not a panacea, but can be an effective approach, and usually a better alternative, than ablative surgery to help alleviate chronic debilitating benign pain in some patients.
Complications are rare, but include the potential for spinal cord injury and infection.
Intraspinal Morphine System Intraspinal morphine, a more recently introduced pain relieving procedure, has been found to be both safe and efficacious, but is a more aggressive technique to use for pain relief. It is usually tried after spinal cord stimulation is deemed not to be effective. Its effectiveness comes because it fills the opiate receptors in the cord, thus blocking the pathway from pain receptors in the periphery. Again, the pain that is most easily relieved is pain confined to the back and lower extremities. A test dose of spinal morphine is utilized to ensure adequate response prior to implanting the system.