THURSDAY, FEBRUARY 6, 2023 (HealthDay News) — Dennis Bassett, 64, has a fresh lease of life after suffering from crippling low back pain for over 30 years.
In the 1980s, he damaged his back while assisting a buddy in Hempstead, New York. He tried everything to get rid of his back pain, including self-medication, acupuncture, and chiropractor work, as well as steroid injections, physical therapy, and exercise.
“My back just got worse,” the former real estate professional remembered. “Some days, I couldn’t even get inside the home or up my stairs.”
But that was back then.
Everything changed a few months ago when his doctor offered a new treatment involving the implantation of a muscle-stimulating device called the ReActiv8 into his lower back to reawaken a dormant and withering core muscle. The gadget was approved by the US Food and Drug Administration in June 2020.
The treatment was performed some months ago at Lenox Health Greenwich Village in New York City on the father of six. He is now thinking of relocating to the South and starting a trucking company.
“I feel good enough to take a chance,” he explained. “I have no trouble walking upstairs, sitting down, or standing up. “I thought to myself, ‘this is too wonderful to be true.'”
But, when combined with the proper patient, this operation isn’t too good to be true, according to Bassett’s surgeon, Dr. Kiran Vithal Patel, director of pain management at Lenox Hill Hospital in New York City.
“This is a once-in-a-lifetime operation because it is restorative, disease-modifying, may prevent additional degeneration, and allows patients to be considerably more active than they were,” she added.
According to Patel, it is not appropriate for everyone suffering from low back discomfort. “This treatment is for patients who have had persistent lower back pain for more than six months and have not responded to physical therapy, anti-inflammatory medication, and all of the other conservative measures we use,” she noted. MRI scans also indicate no evidence of structural damage.
Bassett suffers from a weak multifidus muscle in his lower back. Walking, sitting, and bending all rely on this muscle.
“By activating the multifidus muscle using ReActiv8, we may stop the pain cycle and allow the patient to restore core stability, preventing additional damage to discs, nerves, or facet joints in their back,” Patel explained.
During the outpatient operation, a surgeon puts an electrode on either side of the multifidus muscle and implants the ReActiv8 pulse generator, which is approximately the size of a tiny dental floss, into the patient’s lower back. The generator sends electrical pulses to the nerves in order to activate the multifidus muscle.
Patients tense and relax their muscles for 30 minutes twice a day with a wireless remote control, strengthening them. Following the treatment, there is little downtime. For a few days, most people are mildly painful.
There is one possible disadvantage: expense. The operation might be costly. Patel is attempting to get more private insurance companies to foot the tab. Neurostimulation insurance companies often pay between $20,000 and $32,000 for the operation. According to a business spokeswoman, if insurance is not an option, Mainstay Medical would negotiate with the patient, surgeon, or hospital on a sliding scale to pay the costs.
According to Dr. Dawood Sayed, division chief of pain management at the University of Kansas Health System in Kansas City, there haven’t been many outstanding therapies for low back pain caused by a weak multifidus muscle. He participated in clinical studies that led to the device’s approval and has conducted over 60 surgeries both within and outside of the study.
“This plugs a hole in our therapy algorithm,” Sayed explained.
According to him, the gadget is intended for individuals with persistent lower back pain who are not candidates for standard spine surgery and have greater discomfort in their lower back than in their legs.
“Physical therapy, exercise, yoga, chiropractic care, medicines, and even injections can’t get that muscle to activate appropriately in a particular population of people,” Sayed explained. “The gadget uses tiny electric wires to stimulate the nerve that essentially controls the primary muscle.”
Who will benefit from this surgery, and how can you tell? The condition of the multifidus muscle in the lower back is the decisive factor. “The MRI will let us detect if the muscle has thinned or atrophied since it appears that muscle is being replaced by fat,” he explained.
According to research, pain alleviation following the surgery begins gradually and lasts at least three years. “”At one year, patients are doing well, even better at two years, and three-year results show continuous gains,” Sayed stated. At three years, 83% of participants in a corporate study saw “substantial and clinically relevant improvements” in pain or disability, or both.
“This is the first neurostimulator implant that is more of a restoration therapy to bring folks back to where they were and get the muscle firing,” he continues.
And, in rare cases, the gadget can be withdrawn once the discomfort has subsided.
Sayed is optimistic that more commercial insurers would begin to pay the procedure’s costs. “It saves money because individuals don’t have to go to the emergency room, take pain meds, or miss work because of back discomfort,” he says.
Additional information
More information about managing low back pain may be found at the American Academy of Orthopaedic Surgeons.
Dennis Bassett, Hempstead, New York; Kiran Vithal Patel, MD, director of pain medicine at Lenox Hill Hospital in New York City; and Dawood Sayed, MD, division chief of pain medicine at The University of Kansas Health System in Kansas City.
Erin Balsa is a highly skilled and knowledgeable health journalist with a passion for educating the public on important health and wellness topics. With extensive experience in both traditional and digital media, Erin has established herself as a trusted voice in the field.