Dr. Taghva is a national and worldwide expert on spinal cord stimulation, with over 1000 implanted patients as well as involvement in highly-cited studies including the SUNBURST trial. Patients who are successful with spinal cord stimulation often have nerve related pain in the back, legs, neck, arms, or feet. Typically this pain is caused by nerve irritation following spine surgery (failed back surgery syndrome), direct nerve injuries (complex regional pain syndrome), spinal stenosis or radiculopathy, or peripheral neuropathy.
Dr. Taghva is unique in that he is a neurosurgeon with dedicated fellowship training in spinal cord stimulation, and as a result, he routinely performs all aspects of spinal cord stimulation including percutaneous implantation, laminotomy and paddle implantation, as well as complex and routine trials, and complex revision of spinal cord stimulation. In addition, Dr. Taghva has a busy practice of minimallly-invasive spine surgery including artificial disc replacement, microdiscectomy, minimally-invasive laminotomies, and endoscopic spine surgery. Because of this broad experience, Dr. Taghva is able to tailor his surgical approach to individual patients rather than a “one-size fits all” approach.
Dr. Taghva has experience with implantation of all major devices including Nevro HF10, Medtronic, Abbott, and Boston Scientific. Dr. Taghva has a unique philosophy regarding spinal cord stimulation in that he believes many patients with neuropathic (nerve related) pain are misdiagnosed with mechanical pain and are offered, in many cases, unsuccessful fusion operations. In that way, he believes that spinal cord stimulation trials (a minimally invasive outpatient procedure covered by Medicare and most PPO insurance) can be used as both a therapeutic and diagnostic tool for neuropathic pain. Due to this approach, Dr. Taghva is able to spare many patients unnecessary spine surgeries, and has over 80% of spinal cord stimulator patients in his practice achieving benchmarks of 50% pain relief or more.
Dr. Taghva received his medical degree at Johns Hopkins University School of Medicine, his residency at the University of Southern California with fellowship training at The Ohio State University. He is a board-certified neurosurgeon and has been voted by his peers as a Orange County Physician of Excellence consecutively for the past six years as well as being voted a Super Doctors Rising Star.
Board-certified neurosurgeon Alexander Taghva, M.D., F.A.A.N.S. has pioneered an innovative new treatment for chronic pain: endoscopic spinal cord stimulation in Orange County, California. Dr. Taghva is the only practitioner in the area offering this cutting-edge, minimally invasive outpatient procedure, which brings daily relief to those who suffer from chronic pain.
- What is Spinal Cord Stimulation?
- Types of Spinal Cord Stimulation Devices
- Why Should I Choose Spinal Cord Stimulation?
- Am I a Candidate for Spinal Cord Stimulation?
- The Spinal Cord Stimulation Consultation with Dr. Taghva
- Preparing for Spinal Cord Stimulation
- Spinal Cord Stimulation in Mission Viejo – The Surgery
- Recovering from Spinal Cord Stimulation
- Possible Side Effects or Risks of Spinal Cord Stimulation
- Why Should I Choose Dr. Taghva to Perform My Spinal Cord Stimulation?
- Frequently Asked Questions About Spinal Cord Stimulation
What is Spinal Cord Stimulation?
Dr. Alexander Taghva of Mission Viejo, CA, performs spinal cord stimulation using endoscopic techniques. Endoscopic procedures involve the use of an endoscope (a tiny camera attached to a flexible tube) to provide visibility during surgery.
During an SCS procedure, Dr. Taghva guides an endoscope underneath the skin to help him visualize different areas of the spine. An SCS device, or spinal cord stimulation implant, is inserted at the site where the nerves are generating persistent discomfort, providing an electrical output that will interfere with pain signals.
The device replaces chronic pain with a more pleasant feeling called paresthesia, described as a tingling sensation in the area. Other settings or devices will provide different options, including some that do not mask pain with other feelings but actually eliminate pain.
SCS is an effective treatment for pain. Patients have experienced 50-80% relief of their symptoms, with a reduction in pain and negative sensations. If they wish, patients can undergo a trial run before the doctor permanently installs the device. Patients can control the energy output of the spinal cord stimulation device by adjusting the levels as needed to determine the strength of their electrical impulses.
Types of Spinal Cord Stimulation Devices
Advanced research in neurosurgery has created implanted devices for effective chronic pain management, which can be used during SCS in Mission Viejo, CA. These devices include:
Radiofrequency Systems: Radiofrequency systems are typically reserved for complicated cases of extreme pain. RF systems are the most powerful of the three devices currently available for SCS. When fitted with an RF system, a patient will use an external device to power the spinal cord stimulation. The receiver is installed inside the body while the transmitter and antenna are outside the body.
Conventional Systems: Conventional systems are fully internal and require minor surgery when the power source is depleted. After replacement, patients will once again receive the full benefits of the spinal cord stimulation device.
Rechargeable Systems: Rechargeable systems are the latest innovation in SCS devices. Longer-lasting than conventional systems, patients can recharge their power source as needed. When the system can no longer hold a charge through the recharging process, minor surgery is used to replace the system’s power source.
Why Should I Choose Spinal Cord Stimulation?
Orange County spinal cord stimulation is typically only an option for patients who have been unsuccessful candidates of more traditional pain management treatments. Some do not tolerate medications well or may have developed either immunity or dependence on opioids or other drugs that act on the nerves. Physical management, including therapy, might also not be effective on the nerve structures affected.
Endoscopic spinal cord stimulation improves a patient’s quality of life and is less disruptive of sensitive areas in the spine than an open procedure, which requires more surgical cutting. By altering the pain signals that the brain receives, Mission Viejo neurosurgeons and spinal cord stimulation specialist Dr. Taghva can use advanced technology to curb pain in patients who have not had success with other pain management techniques.
Am I a Candidate for Spinal Cord Stimulation?
Patients who have endured at least three months of chronic pain might be candidates for spinal cord stimulation in Orange County. Most often, those who are eligible for an SCS implant have not found relief with other treatments.
Failed back surgery syndrome (FBSS) is a term that encompasses a broad range of symptoms that may occur after unsuccessful spine surgery. A failed back surgery might have been performed to treat various medical conditions, but did not provide the patient with adequate pain relief. SCS patients may also have tried physical therapy, chiropractic manipulations, massage, acupuncture, prescription pain medications, and doctor’s orders to refrain from certain activities.
Common diagnoses that might benefit from spinal cord stimulation are:
- Spinal stenosis
- Herniated disk
- Chronic pain
- Failed prior spinal surgery (spinal surgery revision)
- Parkinson’s disease
Patients accepted for pulse generator implantation must have a condition that will respond to the stimuli of the device. As with any surgery, patients must be healthy enough to undergo the procedure safely. There might be special circumstances related to the central nervous system due to disease progress or the extent of the injury. All factors must be considered during a neurosurgery consultation for SCS in Orange County.
Dr. Taghva’s staff can submit a request to the patient’s insurance, but coverage may vary between companies.
The Spinal Cord Stimulation Consultation with Dr. Taghva
When a prospective patient arrives at Dr. Taghva’s office in Mission Viejo, CA to discuss spinal cord stimulation surgery, the surgeon will begin by assessing the patient’s spinal health.
Dr. Taghva will go over the patient’s medical history, the cause of the pain, and failed pain management treatments that were attempted in the past. In some cases, he will provide both diagnosis and treatment. This may require additional testing outside of the clinic with another healthcare provider to ensure that an implanted electrical device is the best treatment option.
During the first meeting, Dr. Taghva will explain the trial process and the different SCS systems. Patients can first experience the effects of the device through an external unit to learn how the endoscopic version of the procedure can help them.
This trial will last about one week and is considered successful when patients are less reliant on their pain medication regimen with no adverse effects. After it has been determined that Dr. Taghva can provide relief with spinal cord stimulation surgery in Mission Viejo, the procedure can be scheduled.
Preparing for Spinal Cord Stimulation
Before undergoing spinal cord stimulation surgery in Orange County, patients must complete all necessary prerequisites and testing requested by Dr. Taghva. These might include medical imaging, blood tests, and nerve studies.
The doctor will also provide some “dos and don’ts,” leading up to the surgery, such as do discuss your blood thinner regimen with your primary care physician and don’t drink alcohol or smoke leading up to the surgery.
While patients can return home the same day of the procedure, the anesthesia administered prevents them from being able to drive safely. A designated ride must be established prior to the day of treatment. Preparation needs might vary from one patient to the next.
Spinal Cord Stimulation in Mission Viejo – The Surgery
The 90-minute outpatient spinal cord stimulation procedure is completed endoscopically. Rather than cutting through all the tissue to reach the spinal cord, the doctor can make a small incision and view the treatment area through an endoscope.
During this minimally-invasive spine surgery, the stimulation device is placed near the spinal cord using a needle. A small incision is made on the left upper buttock and the pulse generator is inserted.
Patients will have the opportunity to program the device and adjust the electrical impulses through a handheld remote. The patient can adjust the intensity of the signals or even turn off the device if needed.
Following the procedure, patients are discharged home to recover. Patients traveling to the Orange County area to undergo spinal cord stimulation surgery might need to recover in a hotel during their downtime. Patients should plan to visit Dr. Taghva again for at least two post-surgical appointments.
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Recovering from Spinal Cord Stimulation
A week after undergoing spinal cord stimulation, Dr. Taghva’s patients are asked to return to his Mission Viejo office so he can track their progress with the device. A second follow-up appointment is scheduled for the one month postoperatively. In cases where spinal cord stimulation has not been effective, the device can be removed with no damage to the surrounding nerves.
Patients may need up to 8 weeks to recover. In the first week following surgery, it is normal to experience swelling and discomfort at the surgery site. Pain medications and icing are recommended.
Because Dr. Taghva performs spinal cord stimulation in Mission Viejo endoscopically, there is less risk of infection. Still, patients might be required to take sponge baths only for a short while until the small cut is fully closed.
The first two weeks require very limited activity with restrictions on lifting over five pounds, performing activities that strain the body (bending over, twisting), extending the arms above the head, or disrupting the leads. It can take up to 12 weeks for the installed wires to heal into a secure position, and most physical activity should be avoided during this time. Dr. Taghva will provide more specific recovery instructions for each patient.
Possible Side Effects or Risks of Spinal Cord Stimulation
While neurosurgery can be risky by its very nature, Dr. Taghva takes every precaution to ensure the safety and well-being of each patient. He may use imaging to view the structures of the spinal cord and uses an endoscopic approach during surgery to minimize surgical trauma. The minimally invasive nature of the procedure further protects the sensitive network of nerves located in and around the spine. Some complications that can arise following a spinal cord stimulation are the following:
- Defective device
- Shocks or burns
- Nerve damage
- Muscle weakness
Why Should I Choose Dr. Taghva to Perform My Spinal Cord Stimulation?
Alexander Taghva, M.D., F.A.A.N.S. is a board-certified neurosurgeon specializing in minimally invasive procedures and spinal cord stimulation surgery at his Mission Viejo practice. He is one of the top spine pain management specialists in Orange County.
The doctor began his education at the University of Southern California, where he graduated Summa Cum Laude with a degree in biochemistry. He went on to attend Johns Hopkins University School of Medicine and completed his residency at the University of Southern California in neurological surgery. Dr. Taghva then completed a fellowship in neuromodulation and functional neurosurgery at Ohio State University.
The doctor belongs to numerous professional groups and remains current in all advances in neurosurgery. He has been a leader in up-and-coming implant technology because he is passionate about improving his patients’ lives. Learn more about Dr. Taghva here.
Frequently Asked Questions About Spinal Cord Stimulation
The SCS implanted device was first installed in patients around the 1960s. Since then, the field has seen exponential growth. Skilled neurosurgeons like Dr. Taghva now perform the procedure endoscopically, and patients can choose their preferred implant system. Doctors are able to temporarily install an external device so patients can determine if the electrical impulses provide them with pain relief before committing to long-term implementation.
Spinal cord stimulation is known in the world of neurosurgery as an elective or palliative procedure. Though some patients’ pain is crippling, many are able to move about with the help of a heavy pain medication regimen.
The procedure does not change the disease process or improve injuries of the spine, but it does treat the effects: chronic pain. Spinal cord stimulation can relieve much of the regular discomfort a patient feels so they are less reliant upon prescription narcotics, which might cause serious side effects and addiction over time. In this respect, spinal cord stimulation can positively impact a patient’s health.
Like the spinal cord stimulation system, which is implanted near the spine and sends electrical impulses to the nerves to disrupt pain, deep brain stimulation involves an implantation process as well.
First, an electrode is implanted within the brain to reach the targeted location of faulty impulses or tremors. Next, electrodes are attached to wires that connect to an internal pulse generator (IPG). The IPG is secured in the patient’s chest, like a pacemaker device. An external handheld magnet or remote control are used to switch the IPG on or off as needed.
Deep brain stimulation is effective in treating tremors and involuntary muscle movements caused by Parkinson’s disease, multiple sclerosis, and dystonia.
Complex regional pain syndrome is thought to be brought on by issues of the peripheral and central nervous systems, with damage or dysfunction tending to be the leading causes. CRPS causes pain and a change in the look and feel of the affected area in terms of color, temperature, and swelling.
CRPS might cause leg pain, arm pain, or issues with the hands and feet, most commonly after an injury has occurred. CRPS currently exists in two different types. CRPS-I (formerly called reflex sympathetic dystrophy or RSD) occurs without known nerve damage while CRPS-II (formerly called causalgia) occurs with known nerve damage.
The treatment for both types of complex regional pain syndrome is similar. There are a number of treatment options available for CRPS, including spinal cord stimulation in Mission Viejo, CA.