Software Upgrades

Advances in spinal cord stimulation provide superior pain relief.

During her 28-year tenure with the United States Postal Service®, Deborah Boneta performed various functions that shifted as the company’s requirements and her own physical abilities changed.

Photo by Jordan Pysz.

Deborah Boneta

“I delivered mail for 14 years, then worked inside as a mail clerk after that,” Deborah shares. “I preferred delivering mail over being a mail clerk, but I was in a car accident while delivering mail, and that aggravated a longtime back injury.

“All the years of heavy lifting that goes with mail delivery contributed to the back problem, which really started in 2003. I underwent back surgery in 2006, and that helped for a while, but then the pain came back worse than before the surgery.

“At times, it was a radiating pain that went down my back. At other times, it was a stabbing pain. It varied and was excruciating at times, a seven on a scale of one to 10, and it became really bad the last few years that I worked at the post office.

“It became difficult for me to stand for very long because the pain would just come on and not go away. I couldn’t do my normal activities outside of work such as cleaning the house and shopping because if I was on my feet for very long, my back really hurt.”

In search of an answer, Deborah tried physical therapy, chiropractic treatment, even steroid injections, but those therapies failed to bring her sustaining relief.

“Then, I was in another car accident in 2015, and that made the pain even worse,” Deborah recalls. “Once the accident set it off, I needed to find something to relieve the pain. A friend recommended Florida Pain Management Associates, so I decided to check them out to see if they could help me.”

At Florida Pain Management Associates, Deborah met board-certified pain management specialist Harold J. Cordner, MD. Dr. Cordner has a complete arsenal of noninterventional and interventional services for managing his patients’ pain. Dr. Cordner impressed Deborah, so she trusted him immediately. She detailed for him the history of her back pain and her attempts to find relief from it.

“When I initially met with Deborah, she told me she had tried just about everything seeking pain relief,” Dr. Cordner recounts. “She underwent a spinal fusion, epidural cortisone injections and radiofrequency ablations. She tried pain medications, chiropractic manipulations and massage therapy, but all of those treatments failed.

“We decided pretty early on in her treatment to use spinal cord stimulation. We believed that had the highest likelihood of success in relieving Deborah’s pain.”

A spinal cord stimulator is a small device implanted under the skin. It impedes pain by sending gentle electronic waves to the spine. Before a spinal cord stimulator is implanted, Dr. Cordner performs a temporary spinal cord stimualtor trial run to gauge the potential for pain relief from the stimulator.

“I went through a trial for about 10 days,” Deborah recalls. “I felt immediate relief from my pain, so I decided to move forward with the spinal cord stimulator implant. The implant procedure was performed in May 2019.”

New Programming

“When Deborah arrived at our office, we were in the midst of a study on a new programming algorithm for spinal cord stimulation,” Dr. Cordner notes. “The study, called the Differential Target Multiplex, or DTM , looked at a new method of programming stimulators to determine if it results in better pain relief than conventional programming.

“As part of the study, half of the patients were given conventional spinal cord stimulation and half were put into the study arm and received the new programming algorithm. Deborah was part of the study group and responded very well. She reported 80 to 100 percent relief during her stimulator trial.”

“I’m able to do everything I wasn’t able to do before I got the spinal cord stimulator.” – Deborah

Conventional spinal cord stimulator programming, which has been the standard for the past 30 years, specifically targets and stimulates spinal neurons. But basic science research has identified different locations and cells of the spinal cord that can also be targeted to further improve pain relief. That’s the basis of the new programming.

“The three-month data from the DTM study shows that 80 percent of patients using the new programming experienced greater than fifty percent pain relief,” Dr. Cordner reports. “About 50 percent of patients using conventional stimulation experienced relief.

“There is a good possibility that patients who failed spinal cord stimulator trials with conventional stimulation will have success with the new programming algorithm.”

Dr. Cordner and his team have completed enrollment in the DTM study and plan to follow the study patients for 24 months. The study was initially confined to patients who failed back surgery, but researchers are now expanding it to include patients with other pain conditions as well.

Photo by Jordan Pysz.

Spinal cord stimulation has relieved Deborah of her back pain.

“We are opening the study to patient populations outside of the original study,” Dr. Cordner confirms. “We are now looking at patients with cervical problems and those with primarily back and leg pain who have not had surgery.

“The new programming algorithm is proprietary. But as a participant in the DTM study, Florida Pain Management Associates can offer this new technique to our patients. It is not available at other local practices because they were not part of the study.”

Standing Ovation

All of the other treatments and procedures Deborah tried were unsuccessful in relieving her back pain. She finally found relief with the spinal cord stimulator trial, which gave her nearly 100 percent relief. With the success of the trial, the device was permanently implanted, and Deborah is thrilled with the results.

“I’m doing really well,” she enthuses. “I’m not experiencing any pain now, so it’s a zero on a scale of one to 10. And I’m able to do everything I wasn’t able to do before I got the spinal cord stimulator. I can stand for long periods of time now, so I can clean my house and go shopping again.”

Being able to stand is important to Deborah, who is on her feet quite a bit while volunteering in the food pantry at The Salvation Army®. Deborah also volunteers at Carenet Health®, where she helps organize donations to the organization. Now that she can stand without pain, her time spent volunteering is more comfortable and more enjoyable.

The new programming algorithm used by her spinal cord stimulator has successfully relieved Deborah’s debilitating back pain and enabled her to return to her everyday activities. She offers these words of advice for others who suffer with similar pain conditions:

“If you’ve received no pain relief from anything else you’ve tried, I definitely recommend spinal cord stimulation,” Deborah says. “And I highly recommend Dr. Cordner and Florida Pain Management Associates.”

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