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Dr. Neel Mehta
Dr. Neel Mehta

Q: What’s the difference between spinal cord stimulation and radiofrequency ablation?

A: Spinal cord stimulation is a form of neuromodulation (modifying how nerves send signals) used to reduce the back pain you may be experiencing. With spinal cord stimulation, the idea is to slow down the signals coming from the painful area and hopefully lead to a better quality of life and more functional ability.

For example, you may have a pain signal coming from your left leg to your spinal cord and brain. We use a small battery connected to a wire — called a neurostimulator device — that sits parallel to your spinal cord. It uses electrical activity to block the pain that you feel. The concept is similar to a pacemaker for the heart, which uses electrical activity to help control your heart rhythm and improve its function. The spinal cord stimulator is an implantable device. However, there is a noninvasive, external device that the patient can first use for a test drive. This allows the patient to try it out at home to see if it makes a meaningful difference in their pain.

Radiofrequency ablation is a type of injection procedure that uses electrical energy to generate heat and, in essence, almost destroy the nerve. This prevents or slows down the nerve from sending pain signals to the brain. We generally do ablation on sensory nerves (which sense pain) and not motor nerves (which control function). We most commonly do ablation techniques on the facet joints with tiny nerves whose sole purpose is to detect pain. When facet joints develop arthritis, ablation techniques can be beneficial.

Dr. Neel Mehta, pain management physician

This question was answered during the episode of Spine Time called “It Didn’t Work the First Time.” A recording of this webinar held on July 8, 2020, is available on YouTube.

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