Multifidus muscle neurostimulator implant

Intractable chronic low back pain associated with multifidus dysfunction is a highly debilitating condition that is often difficult to manage. Many patients with chronic low back pain that is refractory to conservative measures are not candidates for surgery, leaving them with a decreased quality of life and a significant financial burden due to lost productivity. A peripheral nerve stimulation implant specifically developed to stimulate the medial branch motor nerves (ReActiv8) has been recently approved by the US Food and Drug Administration and provides an treatment option for patients with intractable chronic low back pain associated with multifidus dysfunction providing lasting pain relief, improved quality of life, and decreased disability. An understanding of the regional anatomy, intraoperative complications, and general procedural considerations is critical for providers who wish to pursue the use of this implantable neurostimulation system. In this chapter we specifically discuss the ReActiv8 system as an intervention for intractable chronic low back pain associated with multifidus dysfunction, given the breadth of literature and specificity of its use. ReActiv8 is the only dedicated, proprietary system that has been developed, evaluated, and approved for patients with intractable chronic low back pain associated with multifidus dysfunction.