At Pelisyonkis Langone’s Center for Neuromodulation, we offer several technologically advanced treatment options for people dealing with conditions such as Parkinson’s disease, movement disorders, and chronic pain.
Deep Brain Stimulation
Our deep brain stimulation (DBS) program is one of the country’s most active—we perform more than 100 procedures each year. Conditions we use DBS to manage include Parkinson’s disease, essential tremor, dystonia, obsessive-compulsive disorder, Tourette syndrome, and severe depression. DBS has also been used as an experimental treatment for other neurological disorders such as Huntington’s disease and cluster headache.
Spinal Cord Stimulation
Spinal cord stimulation (SCS) is a surgical procedure used to manage chronic pain in the arms, legs, and back that may result from many conditions, including complex regional pain syndrome and failed back surgery syndrome. Electrodes are placed over the lining of the spinal cord, known as the dura, to deliver stimulation.
SCS is performed in two separate stages: a trial procedure, followed by a permanent implant if the trial is successful. Each stage takes between one and two hours, and the vast majority of these surgeries are done as an outpatient.
Stage one involves implanting trial electrodes, via small needles, which are then connected to an external battery and programmer. We ask you to try the stimulation at home for a week and assess its ability to provide pain relief. The electrodes are easily removed in the office approximately one week later.
If the trial demonstrates a significant improvement in your pain, permanent implantation can take place during a short surgical procedure. The trial electrodes are removed and permanent ones are put in place and connected to a pacemaker-like device that is implanted under your skin.
After the procedure, you are taught to use the device to control pain as needed. Adjustments to the strength and location of stimulation can be easily made via a handheld remote control.
Peripheral neurostimulation (PNS) is a surgical procedure used to treat patients with chronic headaches or facial pain. Electrodes are placed under the skin of the scalp or area of the face where the pain is occurring and then connected to a pacemaker-like device that is also implanted beneath the skin. Electrical stimulation is applied to the affected area, which multiple studies have proven to be highly effective in decreasing the severity and frequency of headache or facial pain.
The outpatient PNS procedure is performed in two separate hour-long stages. The first stage uses trial electrodes, with a number of stimulation programs administered over the next few days. If this trial demonstrates a significant improvement in your headache or facial pain, permanent implantation can take place.
In stage two, a permanent set of electrodes are implanted and then connected to a small pacemaker-like device that is inserted under the skin in the chest, abdomen, or back. The specific device used is tailored to each person’s needs. After implantation, we teach you how to use the device to control pain as needed. Adjustments to the strength and location of stimulation can be easily made via a handheld remote control.
Intrathecal Pump Placement
In patients with debilitating spasticity, such as children with cerebral palsy or adults after stroke, as well as people with multiple sclerosis or spinal cord injury, a small catheter can be placed into the spinal fluid and connected to a medication pump under the skin. This pump delivers highly potent baclofen, a medication that helps relax muscles and stop cramping.