Meet the Doctor: Giancarlo Barolat, MD | by Mary W. Lemma

Giancarlo Barolat, MD

Posted on Wed, Apr 3, 2013

Dr. Giancarlo Barolat is a leading neurosurgeon in pain management and a pioneer in spinal cord stimulation. He heads Barolat Neurosciences, which specializes in the comprehensive evaluation and management of individuals affected by long-standing, severe pain syndromes that have not responded to conventional medical and surgical treatments. Barolat is affiliated with Presbyterian/St. Luke’s Medical Center.

How do spinal cord stimulation and neuro-implantation work?

In general terms, the “neuro-stimulators” work by modifying or blocking unwanted signals traveling through the nerves and the spinal cord.

What can neuro-implantation treat?

The most widespread use is severe chronic pain that has not responded to any other treatment.Such pain iincludes low back, or pelvic or foot pain; headaches, nerve injury pain and many other painful conditions. Implantation can also treat malfunction of the bladder, epilepsy, Parkinson’s disease, spasticity following a stroke or spinal cord injury, fibromyalgia and fecal incontinence.

Who is most likely to benefit?

Patient are referred to me from all over the country; most have tried just about every treatment available and have been told that there was nothing else to do. Many have endured unbearable pain and resulting changes in life circumstances; some have even considered or attempted suicide, or have been abandoned by their spouse and friends. Every patient I see is deserving of the utmost respect and compassion.

A candidate for spinal cord stimulation and neuro-implantation must demonstrate a willingness to work with the implanting team and grasp an understanding of the procedure. We assess and encourage a support system for every candidate. The more support, the better.

What does the procedure feel like, and are there side effects?

When the stimulation is activated, the patient feels a tingling sensation. In the case of pain, the tingling sensation might replace or reduce the painful sensation. Side effects are usually related to the fact that implantation of the device requires surgical intervention.

For example, if the patient experiences discomfort at the site of the battery implant, the battery can be relocated.

Another possible scenario is loss of stimulation (and related pain relief) due to the electrode wires breaking. In that case the wires can be replaced.

If an infection of the implant occurs, the whole system must be removed surgically. Once the infection clears, however, the system can be re-implanted.

The battery has a life of 5 – 15 years so must be replaced when it stops working. It’s a 20-minute outpatient surgery.

What’s on the horizon for pain management and motor disorder technologies?

These fields are growing by leaps and bounds. As you know, new drugs are being tested all the time. Neuro-implantable technologies have a very bright future, since electrical stimulation does not have any of the side effects of drugs and, given the proper knowledge, can be applied to many chronic conditions. The miniaturization of the electronic circuitries is leading to smaller and smaller implanted devices. This increases their efficacy and acceptance by patients.

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  1. Andrea McCarter-Bostwick says:

    I am looking for assistance with a Spinal Cord Stimulator/revision and/or peripheral nerve stimulator to assist with chronic pain due to nerve injury. This pain has taken over my life as well as that of my family’s too. Please help.
    Thank you for your consideration.

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