A spinal cord stimulator (SCS) device is surgically placed under your skin and sends a mild electric current to your spinal cord (Fig. 1). A small wire carries the current from a pulse generator to the nerve fibers of the spinal cord. When turned on, the SCS stimulates the nerves in the area where your pain is felt. Pain is reduced because the electrical pulses modify and mask the pain signal from reaching your brain.
There are several types of SCS device systems. However, all have three main parts:
Who performs the procedure for Spinal Cord Stimulation?
Neurosurgeons and doctors who specialize in pain management (an anesthesiologist or physiatrist) implant spinal cord stimulators. You can use the free tool below to find doctors and clinics who provide SCS treatment:
What are the results for Spinal Cord Stimulation?
The results of Spinal Cord Stimulation (SCS) depend on careful patient selection, successful trial stimulation, proper surgical technique, and patient education. According to Mayfield Clinic, Stimulation does not cure the condition that is causing pain. Rather, it helps patients manage the pain. SCS is considered successful if pain is reduced by at least half.
Published studies of Spinal Cord Stimulation show good to excellent long-term relief in 50 to 80% of patients suffering from chronic pain [1-6]. One study reports that 24% of patients improved sufficiently to return to gainful employment or housework with stimulation alone or with the addition of occasional oral pain medication [7].
Spinal cord stimulation (SCS) therapy is reversible. If a patient decides at any time to discontinue, the electrode wires and generator can all be removed.
What are the risks of Spinal Cord Stimulation (SCS)?
No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. According to Mayfield Clinic, specific complications related to SCS may include:
Conditions for which you might need additional surgery include movement of the lead, breakage of the lead or extension wire, or (in rare cases) mechanical failure of the device. Reasons for removal of the device include infection and failure to relieve pain.
Sometimes scar tissue develops around the electrode and can make the stimulation less effective.
Living with a Spinal Cord Stimulator
Once the SCS has been programmed, you are sent home with instructions for regulating the stimulation by controlling the strength and the duration of each stimulation period. Your doctor may alter the pulse width, amplitude, and frequencies on follow-up visits if necessary.
The pulse generator has programmable settings:
The handheld programmer lets you turn the stimulator on and off, select programs, and adjust the strength of the stimulation. Most people are given multiple programs to achieve the best possible pain relief at any point throughout the day or during specific activities. You can use your spinal cord stimulator around the clock if necessary.
Some people feel differences in stimulation intensity depending on their position (e.g., sitting versus standing). This is caused by variations in the spread of electricity as you change positions and is normal.
Just like a cardiac pacemaker, your stimulator cannot be damaged by devices such as cellular phones, pagers, microwaves, security doors, and anti-theft sensors. Be sure to carry your Implanted Device Identification card when flying, since the device is detected at airport security gates. Department store and airport security gates or theft detectors may cause an increase or decrease in stimulation when you pass through the gate. This sensation is temporary and should not harm your system. However, as a precaution, you should turn off your system before passing through security gates.
The various SCS systems have different restrictions to their use with MRI, ultrasound, defibrillator, electrocautery, diathermy, and cardiac pacemakers. Be sure to know the limitations of your specific SCS device. Also, chiropractic manipulation may cause the lead to move. Consult your surgeon first.
