Spinal Cord Stimulators

Spinal cord stimulators, a specialized treatment option designed to relieve chronic back pain and related conditions by delivering electrical impulses to the spinal cord.

A spinal cord stimulator (SCS) is an implanted medical device that sends low-level electrical signals directly into the spinal cord. These impulses alter or mask pain signals before they reach the brain, thereby reducing the perception of pain in the back and other affected areas. In the procedure, thin wires with electrodes are placed in the epidural space around the spinal cord, and a small generator implanted under the skin powers the system.

Spinal cord stimulation is generally considered for patients who:

• Have chronic, intractable pain in the torso or limbs, such as due to failed back surgery, chronic regional pain syndrome, or neuropathic pain after spinal surgery.
• Have not responded to at least 6 months of conservative treatments such as medications or physical therapy.

Benefits of Spinal Cord Stimulators

• Non-opioid pain management option
• Customizable and reversable pain control offers long-term relief.
• Minimally invasive procedure
• Improved quality of life by reducing pain and improving function.

The Procedure

A required trial period with the device to confirm effectiveness and allow patients to carefully evaluate their results before a permanent procedure is performed. This involves placing temporary electrodes in the epidural pace under x-ray guidance in an outpatient setting. The generator connected to these electrodes is worn outside the body. The trial period typically lasts about one week while the patient tracks the pain relief experienced. A trial is considered successful if the patient experiences a 50% or greater reduction in pain.

If a trial is successful, permanent surgery can be scheduled to anchor the electrodes and implant the generator under the skin, usually in the lower abdomen or upper buttock area. The procedure is usually performed outpatient and generally lasts 1-2 hours using local anesthesia and sedation.

Recovery from SCS implantation is generally quick and light activities are usually resumed within days, although strenuous physical activity should be avoided for several weeks. Follow-up visits are necessary for device programming and monitoring.

Effectiveness

SCS is considered successful if it provides at least a 50% reduction in pain intensity during the trial and long-term benefits for chronic low back pain have been shown to provide significant pain relief and improved function in many patients, although individual outcomes may vary.

Possible Side effects and Risks

Serious complications are uncommon but can include spinal fluid leaks or allergic reactions. Risks can include infection, bleeding, nerve damage from surgery, or hardware malfunction. Some patients may experience uncomfortable sensations or overstimulation that can be adjusted by reprogramming.