First restorative neurostimulation implantation performed at WVU Medicine 

MORGANTOWN, W.VA. – The Neurosurgery Department at the WVU Rockefeller Neuroscience Institute (RNI) recently implanted WVU Medicine’s first restorative neurostimulation therapy for low back pain. The implant is one of the latest ways to help patients suffering from chronic refractory low back pain with multifidus muscle dysfunction, who otherwise are not candidates for spine surgery. 

Low back pain affects millions of Americans of all ages and incurs billions of dollars in expenses. It is the most frequent cause of job-related disability and a leading contributor to missed workdays and visits to physicians.  

While patients with structural spine issues can often be effectively treated with spine surgery, not all low back pain patients have surgically treatable conditions, leaving many with chronic, debilitating pain. Dysfunction of the multifidus muscle, a key spine stabilizer, can result in functional intersegmental lumbar instability causing pain, which differs from structural spine issue. 

This new surgical solution, known commercially as the ReActiv8® System, is performed on an outpatient basis. It involves placing small wires, or leads, outside the spine next to the nerves that control the multifidus muscle. These leads are connected to a battery that is also implanted under the skin. Patients control the system to perform two short therapy sessions a day, typically when they wake up and when they go to bed in the evening. 

“People who have consistent, debilitating back pain often feel ‘functionally unstable’ in their spine. They can have bouts of back pain doing even light tasks, like brushing teeth and loading dishes,” Manish Ranjan, M.D., RNI neurosurgeon who performed the first implant, said.  

“If physical therapy alone or other standards of medical care, including destructive pain blocking procedures like nerve ablation, have not sufficiently reduced the pain, ReActiv8 neurostimulation can be a wonderful solution.” 

This therapy is markedly different than spinal cord stimulation therapy, which is another routinely performed neuromodulation therapy meant to treat neuropathic pain.  

“Restorative neurostimulation therapy provides a viable treatment option for patients with debilitating chronic low back pain secondary to multifidus muscle dysfunction when other therapies are not effective,” Dr. Ranjan said. 

Unlike other treatments that focus on blocking a pain generator or eliminating movement of the spine, restorative neurostimulation focuses on addressing the root cause of patients with mechanical chronic low back pain caused by multifidus dysfunction.  

Restorative neurostimulation also restores the body’s natural ability to dynamically control the multifidus muscle allowing patients to continue pursuing their favorite activities and help in their functional restoration. 

For more information on the WVU Rockefeller Neuroscience Institute, visit WVUMedicine.org/RNI.