Spinal Cord Stimulators
What Are Spinal Cord Stimulators?
A spinal cord stimulator uses low voltage stimulation of the spinal nerves to block the feeling of pain. The mild electric current is delivered through a pulse generating device that is surgically implanted under the skin. The stimulation feels like a mild tingling in the area where the current is placed. Pain is reduced because the electrical current interrupts the pain signal from reaching the brain.
Spinal cord stimulation may be an option for patients with chronic pain associated with sciatica, failed back surgery, or nerve pain, who have not benefited from more conservative therapies.
For many patients medications and injections may not completely eliminate your pain, or reduce it enough for you to get back to living life to the fullest. Fortunately, the physicians at Sound Pain Alliance are well versed and experienced with using spinal cord stimulation (also known as neuromodulation) to help treat patients’ pain. Spinal cord stimulation is a minimally invasive surgery that uses small electrodes (leads) to deliver electrical current to the nerves in your spine to treat your pain.
A trial is first performed for patients to assess whether or not spinal cord stimulation may help your pain. This trial consists of placing the small leads into the epidural space under fluoroscopic (x-ray) guidance. The trial is quick, and can be done under local anesthesia only or with sedation. After the leads are in place and secured with tape to your back, you will go home and see how it worked for 5-7 days. After the trial period the leads are painlessly pulled out of the epidural space in the office.
If the trial was a success then the next phase is placing a more permanent system. This is an outpatient minimally invasive surgery typically done with sedation. It consists of placing the pulse generator (battery) and leads completely under the skin. You will follow up back in the office several days later to make sure everything is healing well.
Throughout the trial and the implant process, you will be in close contact with a representative from the spinal cord stimulation device company to ensure the best possible results and reduction in your pain. They will help assist you become pain free.
Prior to having a permanent placement of a spinal cord stimulator a patient will undergo a trial procedure in which leads are placed in the epidural space of the spinal cord and are programmed to relieve the patient’s pain. These temporary leads are removed after 7-10 days.
During a permanent spinal cord stimulator surgery, Sound Pain Alliance Providers implant the device using a three-step process:
- Placement of the surgical lead in the epidural space of the spinal cord.
- Tunneling the leads under the skin to the pulse generator pocket and attaching them to the pulse generator after it is placed.
- Placement of the pulse generator in the buttock or abdomen.
- During SCS implantation, there is a risk for bleeding, infection, pain at the site of surgery, nerve damage or (rarely) paralysis.
- In some people, scar tissue may build up over the electrode at the end of the lead, blocking the stimulator’s electrical impulse from reaching its target. In addition, the lead may move or shift, sending stimulation to the wrong location, or the neurostimulator could shift beneath the skin making it painful, hard to charge the battery or communicate with the handheld remote.
- There is also a small risk that the lead could break or the stimulator could malfunction and require replacement.
- Finally, some patients may respond well to SCS at first, but later develop a tolerance to the therapy. In this case, the pain comes back because the nerves stop responding to neuromodulation.
In addition to reducing pain, other important benefits of SCS include:
- Improved functioning
- Increased activity and mobility
- Reduced opioid [narcotic] use
- Less need for other pain medications
- Less dependence on bracing
- Improved sleep
The effects of SCS vary from person to person, and it is important to understand that SCS may help reduce your pain, but not eliminate it.