Mayfield Clinic is first in region to implant Boston Scientific's Precision Spectra™ spinal cord stimulator for chronic pain
CINCINNATI – Tann Nichols, MD, a neurosurgeon with the Mayfield Clinic, has become the first physician in both Ohio and Kentucky to implant a next-generation spinal cord stimulator for the treatment of chronic pain. The new Precision Spectra Spinal Cord Stimulator System™ allows for the doubling of the points of contact on the spinal cord from 16 to 32, resulting in an expanded level of pain coverage.
Dr. Nichols achieved the dual firsts when he performed the surgical procedure on a 55-year-old woman on Feb. 12, 2013, at The Christ Hospital Spine Surgery Center in Norwood, Ohio, and a 68-year-old woman at the St. Elizabeth Edgewood hospital in Kentucky the next day.
The Precision Spectra™, marketed by Boston Scientific, was approved by the U.S. Food & Drug Administration in December 2012 and was unveiled at the American Academy of Pain Medicine in Ft. Lauderdale, Fla., on April 12. The Mayfield Clinic was one of a few select sites across the United States that had early access to the new pain management device, which is now being widely released across the United States.
Spinal cord stimulation delivers electrical pulses from an implantable device to interrupt pain signals and prevent them from reaching the brain. It has been used to treat chronic pain since the 1970s. The Precision Spectra™ breaks new ground with by offering 32 contacts and four lead ports, double the number offered by previous spinal cord stimulation systems. It enables doctors to pinpoint pain transmitters from 150,000 possible points along the spinal cord, thereby hitting the focal point, or “sweet spot,” of each patient’s pain.
“Spectra™ is the next generation of spinal cord stimulation,” Dr. Nichols says. “It gives us improved flexibility in coverage and programing. It will enable us to help more patients and provide better pain coverage for our patients who suffer chronic pain. We anticipate that many more people will benefit from Spectra™than from prior stimulation options.”
Patients are potential candidates for spinal cord stimulators if they have chronic pain of the trunk or lower limbs; if they suffer neuropathy; or if they have failed back syndrome following one or more spine surgeries. “Often, they have exhausted their other options, either surgical or otherwise,” Dr. Nichols says. “Physical therapy and other conservative treatments have not worked for them, and they often no longer have any remaining surgical options.”
A candidate for spinal cord stimulation first undergoes a stimulation trial, which involves: 1) the careful insertion of electrodes through the skin and into the epidural space, the outermost portion of the spinal canal; and 2) the placement of the pulse generator and battery pack in a temporary position on the patient’s belt or clothing, like a pager. If this trial successfully reduces a patient’s pain, a permanent version of the system with an internalized generator is implanted during a second procedure.
Robert Klickovich, MD, a fellowship-trained pain specialist with Neuroscience Associates in Crestview Hills, Ky., performed the spinal cord stimulator trial with Precision Plus, Boston Scientific’s spinal cord stimulator introduced in 2004. When the trial proved successful, Dr. Klickovich referred the patient to Dr. Nichols at the Mayfield Clinic, and the patient received the new Precision Spectra™ for implant.
Although the number of stimulation points in the Precision Spectra™ has doubled to 32, the electrical current has not changed. The stimulation points, placed along leads that vary in length and width, can be spaced close together or farther apart so as to cover the desired area along the spinal cord. Whereas the stimulating contacts were placed on two leads in the past, the Spectra™ utilizes up to four leads.
The system also offers superior programming and improved stimulation algorithms, which allow more precise programming of the system. Using a wireless control that resembles a smartphone, the patient personally controls the stimulation, allowing real-time adjustments based on his or her current needs.
The Precision Spectra™ will be implanted in patients by five additional Mayfield Clinic neurosurgeons: Ellen Air, MD, PhD, and George Mandybur, MD, who practice in Cincinnati; Arthur Arand, MD, who practices in Fairfield, Middletown, and West Chester, Ohio; Steven Bailey, MD, who practices in Northern Kentucky; and Brad Curt, MD, who practices in West Chester and Middletown, Ohio.
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The Mayfield Clinic is recognized as one of the nation's leading physician organizations for clinical care, education, and research of the spine and brain. Supported by 21 neurosurgeons, five neurointensivists, an interventional radiologist, and a pain specialist, the Clinic treats 25,000 patients from 35 states and 13 countries in a typical year. Mayfield's physicians have pioneered surgical procedures and instrumentation that have revolutionized the medical art of neurosurgery for brain tumors and neurovascular diseases and disorders.