2024-03-02 16:01:00
the essentials For the first time in the Gers, patients were implanted with a spinal cord neurostimulator at the Auch hospital. A last resort device to combat chronic pain. Reporting.
In France, just over a hundred neurologic surgeons and specialized anesthetists perform this particular intervention: the implantation of a spinal cord neurostimulator. In the region, there are even fewer. This Thursday, February 29, Auch hospital welcomed two patients. The first, in the Gers, to benefit from this revolutionary treatment for pain.
At 8:30 a.m., the first of them is already installed in the operating room. Aged around forty, he suffers from “Failed Back Surgery Syndrome”. After having undergone a first back operation for pain, the suffering had still not disappeared.
The spine is visible by live x-ray during the procedure. DDM – Aei.B
In the event of chronic pain of neuropathic origin and following the failure of various treatment alternatives, the last resort to relieve patients may be the insertion of a neurostimulator. This technique has been around for several decades. It uses electrical impulses to prevent the pain signal from reaching the brain.
Hide the pain
Non-invasive, the surgery lasts approximately one hour and is fully reimbursed by social security. Obviously, it is subject to a prior multidisciplinary evaluation and well-defined criteria.
This Thursday, surrounded by his team, Dr Jean-Mathieu Mastantuono, anesthetist from L’Isle-Jourdain, is at work. “We will activate the motor fibers of the spinal cord and this will block the pain signal. We can take the example of a level crossing on which the train would be the motor fiber and the car the sensory fiber. When the train passes, the barriers lower and the car cannot pass,” he explains.
The electrode is implanted percutaneously, using a needle, into the spine. DDM – Aei.B
After the electrode has been implanted percutaneously (through the skin), the patient is awakened. It is then connected to a computer to stimulate the painful area. The man then feels tingling in the treated area, which covers the pain: this is paresthesia. The intervention is a success, the electrode is connected to the neurostimulator which is then implanted under the skin. It acts in the same way as a pacemaker.
One in five French people affected by chronic pain
According to the white paper published in 2017 by the French company for the study and treatment of pain, more than 12 million French people suffer from chronic pain, or one in five French people. Pain is the first reason for consultation, at the general practitioner and in emergency services.
During the procedure, stimulation of the painful area is carried out. DDM – Aei.B
For example, in 2019, only 243 patients received treatment for chronic pain. In total, 70% of suffering patients do not receive appropriate treatment for their pain. An observation that has not really changed today.
In France, the implantation of a neurostimulator remains little practiced, not because of its complexity, quite the contrary. “It’s not an interesting enough surgery for neurosurgeons,” emphasizes the anesthesiologist. In addition, the intervention brings little return for the specialty. Not to mention the numerous departures and the closures of pain treatment centers in France. For Dr Mastantuono and Dr Bobet with whom he is partnering to increase the number of interventions at the Auch hospital, relieving his suffering patients seems to be a priority.
“We are aiming for fifty such operations over the year,” reveals the doctor. An ambition which, in the long term, might make the Auscitain hospital the largest center for pain treatment, ahead of Purpan.
A pain treatment center in the Gers
At a time when medical care is raising the debate in France, the Auch hospital is doing well by accelerating its development with this partnership. This comes in two ways: the installation of neurostimulators and the development within the establishment of a pain control center. A unique initiative in the region.
“For several years, the hospital has had a “chronic pain” structure. It is a consultation that we have,” explains the management of the establishment, represented by Sylvie Lacarriere. Psychologists, nurses and doctors receive patients in consultations (funded by ARS Occitanie, Editor’s note).
Each year, approximately 500 consultations are carried out. Today, this medical offer has just been completed by Dr Mastantuono and Dr Bobet, two anesthetists from Lislois. “This is a different level since we are going to carry out actions, we are going to treat.”
Regional influence
The intervention which concerned two patients this Thursday, February 29, is therefore part of a brand new project hosted by the Auscitain hospital center: that of the deployment of a health cooperation group for the treatment of pain. Good news for patients who will see consultation times shorten.
According to the findings of the French company for the study and treatment of pain, less than 3% of chronic pain patients benefit from treatment in a specialized center. Which are severely lacking in resources according to the organization. In hospitals, pain centers are becoming increasingly rare and there is a shortage of staff.
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“Our model is based on a short hospitalization during which the patient can see several specialists. The care is greatly improved. Everyone worked within the establishment’s medical community to enable us to sign this partnership “, adds Dr Mastantuono.
Furthermore, doctors will remain covered by sector 1 agreements. Patients will therefore not have to pay excess fees, confirms Dr. Bobet. This initiative will not only benefit the local population but also those of neighboring departments.
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