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UC San Diego Health Implants Neurostimulation Device To Help With Chronic Back Pain

Students and faculty walk on a pathway at the UC San Diego campus, September ...

Photo by Jacob Aere

Above: Students and faculty walk on a pathway at the UC San Diego campus, September 28, 2020.

UC San Diego Health completed the first surgery in the nation to implant a device that uses neurostimulation in the form of electrical pulses to key nerves and muscles responsible for stabilizing the lower back, it was announced Thursday.

"We are seeing incredible innovation in using neuromodulation to target chronic pain in a more personalized approach," said Dr. Krishnan Chakravarthy, director of clinical pain research at the UCSD Health Center for Pain Medicine and assistant clinical professor at UCSD School of Medicine.

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"We have learned that over time, patients with mechanical back pain experience degeneration of their multifidus muscle — a series of small, triangular muscle bundles located on either side of the spinal column," Chakravarthy said. "By targeting this muscle with neurostimulation, we can not only reduce pain but potentially restore function."

According to the U.S. Centers for Disease Control and Prevention, one quarter of adults in the United States live with chronic back pain, an ailment that causes more global disability than any other condition.

The device is implanted in an outpatient setting, requiring no more than an hour. During the procedure, the device — roughly the size of a small pager — is placed in the lower back and a pair of stimulation leads are sited on the nerve that enervates the lumbar multifidus muscle responsible for stabilizing the lower back.

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After surgery, patients receive 30 minutes of targeted neurostimulation every day, twice a day, causing the multifidus muscle to contract and strengthen. The stimulation is applied through a patient- controlled remote connected to the device lead.

"We're activating these muscles by stimulating them through an electrical current, which can lead to the improvement of a person's lower back pain, but more importantly, helps them rehabilitate a core stabilizer of the lower back," Chakravarthy said. "In a clinical trial for the device, a significant improvement in pain and function was observed in a majority of patients after just three months, with durable effects lasting almost four years."

Chakravarthy said this treatment demonstrates a paradigm shift in how pain therapies can be used and emphasizes the importance of restorative neurostimulation. Most patients with chronic pain rely on medications for relief, including opioid drugs.

"Traditionally, chronic pain is managed through medication and conservative injection therapies that have their limitations," he said. "What we're seeing now is a positive impact through innovation by providing non- opiate pain therapy alternatives that are implantable, minimally invasive and are certainly redefining the pain-management landscape by providing patients more personalized options."


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