Spinal Cord Stimulator Evaluation
There are many surgical procedures which require a psychological evaluation of the patient prior to implementation (see also Bariatric Surgical Evaluation). The surgeon, hospital, or third party insurance payor may request that candidates for certain procedures undergo such an evaluation in order to optimize outcomes and help ensure a successful treatment plan.
Some patients suffer from chronic pain, particularly back pain that does not remit, despite a long course of a variety of pain management treatments. For these patients, one option that may be proposed is the surgical implantation of a neuromodular device, such as a spinal cord stimulator (SCS). A SCS involves insertion of electrodes connected via wires to an electrical pulse generator (controlled by a remote control) which can control spinal spasms or tightness. Controlling the spasms and pain can improve the patient’s ability to stand, walk, and generally move, thus improving the quality of life.
A psychological evaluation for a SCS should include a thorough history and interview as well as completion of specific tests that assess current emotional functioning. During the interview, the patient is asked to describe the following:
History of chronic pain;
Reasons why the patient is currently choosing this intervention at this time;
Other pain management interventions that have been utilized and their outcomes;
General medical, academic, social, and developmental history.
It is important that the patient has a clear understanding of the procedure and how it may affect their and their loved ones’ lives. The ability to comply with the treatment after the insertion, current and future life stressors, family support, and emotional status are factors that are considered when planning SCS implantation. These factors help determine a successful outcome.