Spinal Cord Stimulators
Article on the uses and techniques of Spinal Cord Stimulation in the management of painful conditions
Introduction to Spinal Cord Stimulators
Spinal Cord Stimulator (SCS) is an implantable medical device used to treat chronic pain of neurological origin. A compact electronic device is surgically implanted in the wall of the lower abdomen and connected by wire to a strip of electrodes placed next to the back of the spinal cord.
For pain control, spinal cord stimulators, also known as neurostimulators, introduce new levels of electrical current to the dorsal portion of the spinal cord to block the sensation of pain. In other words, electrical impulses are used to block pain from being received in the brain. The patient thus feels a mild tingling sensation instead of pain.
The device is implanted during a surgical procedure and may include a fully implanted system with an external power source. The procedure is reversible, which implies that it can be removed at any given point of time by your doctor.
Where are Spinal Cord Stimulators used?
Spinal cord stimulators may be used to manage pain from failed back surgery syndrome or radiculopathy (sciatica or leg pain). Studies indicate that spinal cord stimulation works the best for unresolved neuropathic pain in the trunk or limbs.
However, spinal cord stimulation is generally not considered an option until all other pain relieving therapies such as analgesics, NSAIDs, nerve blocks and even surgery have been unsuccessful.
Who benefits from Spinal Cord Stimulation?
While spinal cord stimulation might not be suitable for every patient suffering from low back pain, it best helps the following situations:
- Conservative treatments have not been successful.
- Surgery is unlikely to be helpful.
- Patient has no untreated drug addictions
- Patient has undergone a psychological evaluation
- Patient does not have a pacemaker or other contraindications
- Trial period with SCS has been successful
Studies indicate that about 50%-70% of patients report decrease in pain with the use of spinal cord stimulators. This enables the patients to return to a more active life and resume with their daily activities.
Spinal Cord Stimulators– The Procedure
The procedure for SCS follows a certain line of order. Here we explain the main steps involved:
Step I – Trial Period
Before a SCS system is permanently implanted, most physicians will recommend a trial period. A temporary stimulator will be implanted during this period for a minimum time of 24 hours. Factors like the patient’s reactions to the sensations of spinal stimulation are monitored.
Step II – Implantation
If step I remains successful, the surgeon will begin the process for implantation. Using a local anesthetic to numb the area, the surgeon will insert the wire lead through a needle or through a small incision. Once the lead has been implanted, the stimulation system will be activated.
The lead is connected to a receiver, which is implanted under the skin usually in the buttocks or abdominal area. Other body areas can also be used depending on the patient’s comfort level.
Article supplied by Dr Chris Jenner