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Neuromodulation

You can find answers of the questions stated below in this article:

  • What is neuromodulation?
  • What are the types of neuromodulation therapy?
  • For which diseases is neuromodulation used?
  • How are neuromodulation devices placed?
  •  How is the process?

 The word “neuromodulation” can be defined as “nervous system regulator.” The applied type of therapy regulates the nervous system malfunction at any part of body. This surgery is covered by SGK in many diseases in our country and it promises hope in treatment of many chronic and progressive diseases considered hopeless cases. As large part of neuromodulation surgeries are covered by SGK, it does not cost as high as it is assumed.  Operations included in neuromodulation therapy types:

  • Deep Brain Stimulation (brain pacemaker)
  • Spinal cord stimulation (spinal cord battery)
  • Sacral stimulation (urinary bladder or hip stimulator)
  • Vagal nerve stimulation (epilepsy stimulator)
  • Baclofen pump

The neuromodulation techniques listed above are used in below stated conditions for treatment and for boosting life quality:

  • For whom and in which diseases is deep brain stimulation (brain pacemaker) applied?
    • Deep brain stimulation surgery can be performed for Parkinson’s disease. (paralysis agitans)
    • Deep brain stimulation surgery can be performed for dystonia. (severe involuntary in whole body)
    • Deep brain stimulation surgery can be performed for essential tremor. (tremor disease)
  • Who are candidates for spinal cord stimulation (spinal cord battery)?
    • In diabetic neuropathy (findings resistant to medication such as sensation of burn, cold, pain in feet and hands caused by diabetes)
    • Pain in extremities which is resistant to treatment (leg and arm pain)
    • In unsuccessful lumbar and neck surgery syndrome (in persisting low-back, leg and neck pain after surgeries such as lumbar or cervical hernia surgeries)
    • Peripheral vascular pain (in pain which is resistant to medications and caused by wounds secondary to vascular disease or by the disease itself)
    • In phantom disease (in pain which is resistant to medication, felt at location of amputated extremity and is physically impossible)
    • Buerger’s disease (in hand, arm, foot, leg pain secondary to smoking and in pain at location of amputated extremity)
    • In pain secondary to cancer which is resistant to medications
    • In complex regional pain
    • In reflex sympathetic dystrophy; spinal cord stimulation can be applied.
  • Who are candidates for sacral stimulation (urinary bladder or hip stimulator)?
    • For people who cannot urinate
    • For people with urinary incontinence
    • For people with frequent micturition
    • For people with urinary urgency and incontinence
    • For people with fecal incontinence
    • For people with chronic constipation; bladder stimulation can be successfully applied.
  • Who are candidates for vagal nerve stimulation (epilepsy stimulator)?
    • Vagal nerve stimulation can be applied for epilepsy resistant to medical therapy.
  • For whom is Baclofen pump applied?
    • Baclofen pump surgery can be successfully performed for people with severe contractions that are resistant to medical treatment (arm, leg, body).

How is treatment decided?

Applying to neuromodulation technique is decided following a meticulous observation by the specialist physician who will perform the implantation and neuromodulation team. If the symptoms can be recovered with simple treatment methods, these methods are primarily preferred. Generally, your primary physician wants to be sure whether other treatment methods will be tried or not and requests that you are examined by specialists from other departments with a multidisciplinary approach before he/she decides that the neuromodulation therapy is the best and most timely option for you.

How does implantation process progress?

Implantation procedure changes depending on the hospital and the surgeon performing the procedure. Generally, electrodes or catheters are placed under local anesthesia. The device implanted can stay in your body as long as you need and they can be removed whenever you wish. Moreover; when the permanent battery is placed, no part of device remains outside your body and everything stays under your skin.

What are advantages of neuromodulation therapy?

The most important common characteristic of neuromodulation devices is that they can be arranged with remote control and they can be turned off anytime. As the device does not cause a damage, it can be completely turned off whenever the patient wants.

Another important common feature is a test period for all devices except for deep brain stimulation. Therefore, a test process is conducted and permanent stimulator is placed if the patient certainly has benefit from the device. This ensures that the prime cost decreases, the procedure will be more affordable and it is decided whether the patient will receive benefit from the treatment or not.