BRAIN
Deep Brain Stimulation
Parkinson’s diseaseDystoniaTremorChronic severe pain
Deep brain stimulation (DBS) uses implanted wires to deliver small electrical pulses to specific parts of the brain. It is used in the treatment of movement disorders including Parkinson’s disease, dystonia and tremor, as well as chronic severe pain. DBS leads are placed in precise brain locations chosen according to the type of symptoms to be addressed.
What the system is made of
1Depth leads that are inserted into the brain
2An implanted pulse generator (IPG): a small box containing a battery and circuitry to produce the stimulus current pulses
3Extension leads that connect the electrode leads to the IPG
Spinal Cord Stimulation
Chronic severe neuropathic pain
Spinal cord stimulation (SCS) is a treatment for chronic severe neuropathic pain. Electrodes are implanted into the spine, just behind the spinal cord. They stimulate the back of the spinal cord, where the nerve fibres that carry sensation run upwards towards the head. Stimulating these fibres aims to mask painful signals with other, less unpleasant sensations, often described as a buzzing feeling.
What the system is made of
1An electrode that is implanted next to the spinal cord
2An implantable pulse generator (IPG): a small box containing a battery and circuitry to produce the stimulus current
Peripheral Nerve Stimulation
Severe, well-defined localised paine.g. groin pain after hernia repair
Peripheral nerve stimulation (PNS) is a treatment for severe pain in a fairly small and well-defined body area. An example is pain in the groin after hernia repair. Electrodes placed under the skin stimulate sensory nerves in the area, which can block the pain signals or mask them with other, less unpleasant feelings such as a buzzing.
What the system is made of
1Electrode wires inserted underneath the skin in the painful area
2An implanted pulse generator (IPG): a small box containing a battery and circuitry to produce the stimulus current
Dorsal Root Ganglion Stimulation
Pain in a specific body region
On each side of the spine, from the top of the neck to the bottom of the back, there are almost 30 “nerve roots” connecting the spinal cord to the arms, body and legs. They carry signals from the brain that control the muscles, and sensory signals in the other direction, including touch and pain.
Where each nerve root enters the spine it has a bulge called the dorsal root ganglion (DRG), a key part of the pathway carrying sensory and pain signals to the spinal cord and on to the brain. Electrical stimulation applied to the DRG can block pain signals from the specific area of the body that nerve root serves.
What the system is made of
1One or more electrodes inserted next to one or more DRGs
2An implantable pulse generator (IPG): a small box containing a battery and circuitry to produce the stimulus current
Intrathecal Drug Delivery
Spasm & spasticityChronic severe malignant painChronic severe non-malignant pain
Intrathecal Drug Delivery (ITDD) systems deliver medication into the cerebrospinal fluid (CSF) in the small “intrathecal space” around the spinal cord. Because the medication goes directly to its site of action, only very small doses are needed, so side-effects are minimised as there is very little medication elsewhere in the body.
What the system is made of
1A fine catheter (tube) implanted into the fluid surrounding the spinal cord
2An implanted programmable pump, adjusted wirelessly with an external programmer