A spinal cord stimulator is a device that delivers mild electrical currents to nerves along the spinal cord. These currents interfere with pain messages that nerves send to the brain and is implanted near the spine. There are three main parts to an SCS device: a lead wire with electrodes, a pulse generator that creates the electrical currents, and a handheld remote control.
Who can benefit from a spinal cord stimulator?
SCS can help treat chronic pain caused by- but not limited to:
- Spinal Stenosis
- Failed Back Surgery Syndrome
- Complex Regional Pain Syndrome
- Peripheral Vascular Disease
- Multiple Sclerosis
Patients that consider using the device usually have been suffering from chronic pain for three or more months and may have had multiple surgeries. You may be a candidate for SCS if conservative therapies have failed and you will not benefit from or do not want additional surgeries.
What are the types?
You will first be given a trial stimulator to see if SCS is right for you, which is a temporary wire connected to an external stimulator. If you determine this is successful in treating your pain, a permanent device will be implanted. Your doctor will determine whether or not to use percutaneous leads, which are put in through a needle and remain in the epidural space, or paddle leads, which are placed through an incision.
Two brands of SCS are:
- Medtronic- The Intellis Platform is the world's smallest implantable SCS. They also offer systems that allow access to MRI anywhere in the body.
- Boston Scientific- The first system with 32 power sources and contacts. Their systems are completely wireless and offer both rechargeable and non-rechargeable battery options.
What are the risks/potential complications of SCS?
There are the general surgery risks such as bleeding, infections, and clots. There are other risks specific to SCS such as allergy, epidural hemorrhage, spinal cord compression, battery failure/leakage, spinal fluid leak, generator or lead migration, and paralysis.
What happens during the treatment/procedure?
The procedure takes up to two hours. You will first be given a sedative. Anesthesia will be applied to the back and buttocks where the leads and generators will be placed. Through an incision, a portion of the bony arch of the of spine is removed and the wires are inserted into the epidural space above the spinal cord. You will then be woken up for test stimulations to ensure correct placement for your pain. You will again be sedated. The doctor will pass the wire from the spine to the buttock where the generator is then placed through a separate incision and attached.
What happens during recovery/rehabilitation?
After surgery, your heart rate, blood pressure, heart rate, and pain levels will be monitored. Your generator will be programmed. Surgical pain is managed with narcotics for two weeks, followed by anti-inflammatory drugs. You may experience spinal headaches which can be aided by drinking caffeinated beverages. Following surgery, avoid bending and twisting, raising arms overhead, and sleeping on your stomach. Slowly resume normal activity and walking is encouraged. Sutures or staples are removed in approximately 10 days.
You and your doctor will determine if this is the right treatment for you. If you have been dealing with chronic pain and have exhausted all other options, consider talking to your doctor about SCS today.
Contact The Pain Center to discuss treatment by filling out our contact form or calling (208) 342-9800!