Spinal cord stimulation (SCS) involves surgical implantation of a small stimulator in the abdomen. Electrical wires run from the unit to the spinal cord, where electrodes are placed near the nerves. This stimulates the spinal cord to interfere with pain signal transmission.
Spinal cord stimulation is used to treat chronic and severe forms of neuropathic (nerve) pain. Nerve pain occurs when there is trauma, injury, or disease that affects the central nervous system, peripheral nervous system, or spinal cord. Neuropathic pain symptoms include stabbing, sharp, or burning pain of the extremities.
With many types of neuropathic pain, the patient has an increased response to mild touch, which is called hypersensitivity. Conditions treated with the SCS device include failed back surgery syndrome, complex regional pain syndrome (CRPS), and neuropathic pain.
Before permanently implanting the device, the pain management specialist will have you undergo a trial stage. This is where leads are placed using needles, and the effectiveness of the devices is tested. If you have a positive experience with the spinal cord stimulation, then you are scheduled for the surgical procedure.
To prepare for the procedure, you should:
Arrange to have someone drive you home, as driving is not allowed for 24 hours post-procedure.
Not eat or drink after midnight (small sips of water with usual medicines is permitted).
Hold blood-thinning medications the specified amount of time prior to the procedure.
A nurse will discuss the dangers and benefits of the procedure, and you must sign an informed consent form. The nurse will have you change into a gown, place an IV catheter in your arm, and attach necessary monitoring devices to your finger and arm.
You will be placed on your back. The abdomen is cleaned with an antimicrobial agent, and the skin is anesthetized with a numbing agent. A small incision is made on the abdomen, and the device is surgically placed. Small wires are threaded to the spinal cord, where tiny leads are placed via a tiny incision at the back. Once the device is positioned, the incision is closed with sutures, and a bandage is applied.
Immediately after the procedure, you are monitored by a nurse for 30-45 minutes. You are discharged home, where you should rest for the remainder of the day. You cannot bend, lift, or do heavy activity for 2-3 weeks, while the incisions heal. You will be told when to return for you follow-up appointment.
Based on many clinical studies, the spinal cord stimulator is 66-90% effective for pain relief. A recent research report found that patients reported pain relief two years after the SCS procedure.
Side effects to medications include itching, rash, dizziness, drowsiness, and nausea. Soreness at the incision site is expected, and this gradually improves. Risks are rare, but include infection, bruising, clumsiness, numbness and weakness of the extremities, nerve injury, and worsening pain. Complications can include scar tissue buildup around an electrode, breakage of an electrode, hardware failure, bladder problems, and leakage of spinal fluid.