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Epidural Stimulation For Spinal Cord Injury In India

“The cost of Epidural Stimulation package for Spinal Cord Injury is USD 35,000. The cost of SCI trial is USD 5,500 – USD 6,000 includes 2 days stay.

The spinal cord controls the main movements of our body and spinal cord injury may impact the limb muscle. The spinal cord is fixed inside the vertebral canal tightly, it is very delicate as any minor damage to it can lead to spinal cord injuries. And a spinal cord injury might be a life-threatening injury because it affects our lives in every aspect mentally, socially, and physically.

Spinal cord injury (SCI) is a shattering experience with unanticipated physical and emotional consequences for patients. As per WHO each year, around the world, between 250,000 and 500,000 people suffer a spinal cord injury (SCI).

Universally, the term ‘spinal cord injury’ refers to any damage to the spinal cord resulting from trauma (e.g., a car crash) or from disease or degeneration (e.g., cancer). There is no reliable estimate of global prevalence, but the estimated annual global incidence is 40 to 80 cases per million population.

Up to 90% of these cases are due to traumatic causes, though the proportion of non-traumatic spinal cord injury appears, to be growing. The majority of spinal cord injuries are due to preventable causes.

The most common causes of spinal cord injury are listed below:

  • Violent encounters including gunshot wounds and knife wounds.
  • Road accidents involving major trauma to the head, neck, chest, or back areas.
  • Injuries and damages caused by sports and recreational activities such as a strong impact on the head or spine during a sporting event or hitting the bottom while diving into shallow water.
  • A fall from a height.

Epidural Stimulation By Spinal Stimulator

If the injury is nontraumatic, the causes usually revolve around infections, inflammation, or erosion of the disks of the spine. Sometimes, cancer and arthritis can also cause nontraumatic spinal cord injury.

The goal of any research about spinal cord injuries is to amplify effective and efficient repair strategies, which may restore motor and sensory functions to near-normal levels. Epidural stimulation for spinal cord injury (SCI), also known as epidural electrical stimulation (EES) and epi-stim the natural way in which the brain-to-spine stimulation pathways are bypassed to begin direct nerve stimulation through the use of electrical currents on the lower part of the spinal cord.

Spinal cord stimulation delivers mild electrical impulses to the spinal cord that interrupt pain signals to the brain, replacing them with a tingling sensation.

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How Does It Work?

Epidural stimulation treatment is a revolutionary procedure for spinal cord injury patients that involves the implantation of a spinal cord stimulator into the epidural space of the spine. The implant is an electrode developed to convey and communicate electrical currents which produce voluntary muscle contraction and movements, of targeted groups of muscles possible. The device emits a continuous electrical current, to the neurological level (lower part) of the spinal cord.

The neurons and axons everywhere in the body generally remain in perfect form post a spinal cord injury. It becomes a problem only when the brain is unable to send and receive signals from them as the pathway or its route gets damaged from the injury. In simple words, Epidural Stimulation treatment for spinal cord injury is the latest form of treatment for spinal cord injury survivors experiencing loss of control over limbs and other lower parts of the spine.

Procedure

An epidural stimulation treatment is surgery that involves the implantation of a spinal cord stimulator into the epidural space of the spine. The implant is an electrode in form of a device that sends mild electrical pulses to the Spinal Cord at a specific region. It acts as a ‘bridge’ and later leads them. It emits an electrical current, which produces voluntary muscle contraction and movements.

Once the stimulator is implanted and stimulator is worked upon by a team of physiotherapists. The intensity and its frequency and the current are customized as per the patient’s body requirement.

  • Local anesthesia is given to numb the area and mild sedation helps to keep the patient relaxed.
  • The stimulation to the spinal cord is induced using the chip which is inserted into the Dura (in neuroanatomy, the dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord) through the insulated thin wires positioned next to to the spinal cord called leads.
  • It helps in refreshing and applying the rest of the undamaged neural pathways within the spinal cord that initiates the movement.
  • This further supports and enables the patients in standing or walking. Therefore, it’s a technique used to treat paralyzed people to do a voluntary movement or people with severe and chronic spinal cord injuries caused by numerous conditions so that they stand a chance to live their life confidently and independently.
  • The frequency and intensity of the electrical current can be regulated with a remote which helps in adjusting the stimulator to particular areas and levels of pain, as per the activities and as per the pain changes during the day. This intervention is referred to as electro-enabling motor control.

The epidural stimulation using a stimulator is a technique that is a two-staged procedure:

The Trial Stage Implant

  • The first is a trial stage, during which the leads (insulated wires) are temporarily placed inside the epidural space through needles to test the usefulness of the device and adaptability to the tingling sensation it delivers.
  • This is an outpatient procedure. Its testing is usually for approximately one week at home or in a hospital in normal surroundings.
  • The leads are effortlessly removed through the skin at the end of the trial, with almost no discomfort to the patient.

Second/Final/ Permanent Stage

  • Only after the stimulator is well accepted by the patient’s body, is a second procedure performed to implant the device permanently in the spinal cord.
  • This is a minor surgical procedure most often done as outpatient surgery, although your doctor may decide to have you stay overnight in the hospital, depending on your individual circumstances. Sometimes patients may be required to be hospitalized for a week as well.
  • It is quite similar to the trial procedure. However, a small incision in the back is given to let the leads be positioned underneath the skin, and another small incision is made for the stimulator to be implanted permanently under the skin, generally in the buttocks or abdominal area.
  • The simulator is hardly noticeable underneath the skin.
  • It has a rechargeable battery that lasts 5 to 10 years, depending on the model and how often it is used.
  • Though SCS is called permanent, it is a reversible therapy. The implanted components can be removed if treatment is not required

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Recovery After Spinal Cord Stimulator in India

Most patients leave the same day as their procedure – once the anesthesia has worn off. For several days after surgery, incisions may be painful. It is advised not to stretch, twist or reach, as it may pull out the incisions.

Dressings are placed over the incision sites, which can be removed after about 3-4 days. In most cases, incisions heal within about 2-4 weeks after surgery.

The doctor discusses the recovery plan, but normally lighter activity is recommended for about 2 weeks after surgery.

Benefits of the Epidural Stimulation Implant in India

The epidural stimulation treatment for spinal cord injury appears to be a more efficient procedure than other chronic pain treatments:

  • Possible Conditions Treated With Scs
  • Complex Regional Pain Syndrome (Crps) / Reflex Sympathetic
  • Dystrophy (Rsd)
  • Phantom Limb Pain
  • Brachial Plexus Injury
  • Failed Back Surgery Syndrome
  • Post-Laminectomy Syndrome
  • Post-Thoracotomy Neuropathic Pain
  • Any Other Neuropathic Pain
  • Spinal Stenosis Not Operable
  • Post-Therapeutic Neuralgia
  • Painful Diabetic Neuropathy
  • Spinal Cord Injury With Paraplegia
  • Occipital Neuralgia
  • Intercostal Neuralgia
  • Post-Hernia Neuropathic Pain
  • Alcohol Painful Neuropathy

Apart from being a treatment for so many conditions, the process of epidural stimulation is undertaken to improve and enrich spinal cord injury-related functions which are related to the cardiovascular and other autonomic nervous systems.

  • It enhances the quality of life.
  • There is progress in the regulation of temperature.
  • Improvement in sexual function.
  • Better bladder control functions.
  • Certain leg movements are also improved.

Generally, the pain relief provided by spinal cord stimulators allows patients to do much more than they could before surgery, which overpowers certain restrictions.

Epidural stimulation is highly effective as a treatment for a condition known as complex regional pain syndrome, or CRPS. It is a condition that affects the extremities, i.e., the arms, legs, hands, and feet through damage to the nerves and nervous system.

Most significantly, people with paralysis have got back on their feet after the epidural stimulation treatment. It is considered to be the most advanced treatment for empowering patients who have lost voluntary control of their limbs.

Epidural Stimulation Cost for Spinal Cord Injury in India

Internationally Epidural Stimulation is an extremely expensive treatment and is not available in many countries. This is why international patients from around the world travel to India, looking for affordable yet high-quality Epidural stimulation treatment in India. Epidural Stimulation treatment is actually quite cost-effective in India, compared to international prices.

The cost of Epidural Stimulation package for Spinal Cord Injury is USD 35,000. The cost of SCI trial is USD 5,500 – USD 6,000 includes 2 days stay.

Success Rate of Epidural Stimulation in India

In the case of an epidural stimulation implant, after stopping all medication when the trial lead was kept for only five days the patient gets 60% relief from the pain.

Every patient getting the epidural stimulation implant experiences different pain relief from the stimulator.

Most successful cases have 50 to 60% decreases in pain after taking the epidural stimulation surgery.

Not to be missed, Epidural stimulation:

  • Lifestyle becomes more active
  • The voluntary movement of limbs starts working.
  • It reduces the medication after having a spinal cord injury.

Epidural Stimulation Surgeries are considered a revolutionary technique for patients with spinal cord injuries to get back on their feet and with incomparable compassion, the Indian culture exhibits add a sparkle to the success of each surgery!

Potential Risks of Epidural Stimulation

Epidural stimulation is still at a growing stage and may have risks associated with it.

It definitely helps patients regain control of some physical capabilities, there may be potential complications involved with the process like any other surgery or treatment.

However, the risks may be considerably minuscule compared to repeated back surgeries which may have a risk of a new complication with each surgery.

Besides, the epidural stimulation treatment for spinal cord injury seems to be a more effective and a full proof procedure than other chronic pain treatments.

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Dr. Surbhi Suden

Verified By Dr. Surbhi Suden

Dr. Surbhi Suden is one of the founders of Lyfboat and a doctor with a renowned name in the Medical tourism industry. She has been working with international patients since 2008 and is a deeply committed professional with a long term vision of transforming the current healthcare scenarios.
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