Spinal Cord Stimulation
In spinal cord stimulation (SCS), a small device called a spinal cord stimulator is implanted in the lower back or abdomen. The stimulator sends electrical pulses to the spinal cord to manage chronic pain. SCS is typically a two-part process that includes a trial phase and then permanent implantation if the trial is successful.
While it doesn’t cure the underlying condition, spinal cord stimulation can offer long-term pain management and improve overall quality of life.
Spinal Cord Stimulator Trial
Before permanent implantation, a temporary spinal cord stimulator is placed externally on the body, and wires are inserted under the skin to deliver electrodes to the spine. The procedure is minimally invasive, performed with local anesthetic and intravenous sedation, and typically lasts 3-7 days. If the patient experiences significant pain relief during the trial, they can proceed with permanent implantation.
Spinal Cord Stimulator Implantation
Permanent spinal cord stimulation involves surgically implanting a small generator (similar to a pacemaker) connected to electrodes and placed near the spinal cord that the patient adjusts with a remote to fine-tune relief based on their symptoms and daily activities.
General anesthesia is typically not needed for the implantation of the spinal cord stimulator. Instead, patients receive local anesthesia and intravenous sedation.
How does spinal cord stimulation work?
The electrical signals sent by the spinal cord stimulator replace the pain sensation with a tingling sensation. The electrical signals sent by the spinal cord stimulator replace the pain sensation with a tingling sensation. These gentle pulses interfere with the nerve signals that carry pain messages to the brain, essentially masking the pain before it can be fully felt.
What conditions does spinal cord stimulation treat?
While not a cure, SCS can significantly reduce pain and improve many patients' daily function and quality of life. It’s commonly used when pain persists after one or more spinal surgeries. It’s also helpful for patients with peripheral neuropathy, radiculopathy, or chronic leg and back pain related to nerve damage or irritation.
What are the benefits of SCS?
SCS can reduce pain by 50 percent or more and help restore a patient’s activity level. It might also reduce the need for narcotic medications.
What is spinal cord stimulation revision?
Spinal cord stimulation revision is a surgical procedure in which the implanted device is adjusted or replaced to optimize the treatment, address complications, and improve patient outcomes. After the revision, the device may need to be reprogrammed, and the patient will undergo follow-up care to ensure the stimulator is functioning optimally.
What is spinal cord stimulation explantation?
During SCS explantation, the implanted spinal cord stimulator device and its components are surgically removed. This phase may be necessary for various reasons, including when the treatment is no longer effective or required.
What are the side effects of spinal cord stimulation?
SCS is a safe and widely used treatment for chronic pain, but like any medical procedure, it may come with certain side effects. Some patients may experience mild to moderate discomfort after the device is implanted and a tingling or buzzing sensation from the stimulation itself, which can take time to adjust to.
Other potential side effects include infection at the implant site, lead migration, or displacement, which could reduce the device's effectiveness.
Will I be able to feel or hear my spinal cord stimulator?
The spinal cord stimulator does not make any noise. However, it might be felt as a large lump under the skin and is not typically seen under clothing.
Will I be able to control the spinal cord stimulator?
Yes. Spinal cord stimulators are designed to be adjustable and controlled via a small, handheld remote control that allows the patient to turn the device on or off, adjust the intensity, and switch between customized, programmed settings.
Who is a candidate for spinal cord stimulation?
SCS may be an option for individuals who have chronic pain that has not responded well to other treatments, including medication, physical therapy, or surgery.
Who should not have the procedure?
Patients who take medications that affect blood coagulation (Coumadin, Plavix, Ticlid, for example) should not have the procedure without further discussion with their doctor.
Is spinal cord stimulation implantation painful?
The procedure for implanting a spinal cord stimulator is generally performed under local anesthesia and sedation, so patients are not typically awake or in pain during the procedure itself. Afterward, the patient may experience discomfort, such as soreness around the implant site, which is common but manageable with pain medication and rest. The pain typically diminishes within a few days to a week as the body heals.
How soon can I return to normal activities after SCS?
Most patients can resume light activities within a few days to a week. However, to allow the body to heal properly, it's important to avoid strenuous activities, heavy lifting, or twisting movements for about four to six weeks.