Spinal Cord Stimulation

Spinal Cord Stimulation by Dr. Vivek Loomba

 

Spinal Cord stimulation is a chronic pain reliever therapy used to block pain signals from reaching the brain. It helps in managing your pain from the chronic back, neck, or leg with a reduction in the use of opioid medications. It provides long-lasting pain relief without any side effects. 

What is Spinal Cord Stimulation?

If you suffer from chronic pain, you may have heard of spinal cord stimulation (SCS) as a possible treatment option. SCS is a type of electrical nerve stimulation that can help to relieve pain in the lower back, legs, and arms. It is typically used when other treatments, such as medication or surgery, have not been successful in relieving pain.

SCS works by sending electrical impulses to the spinal cord to interfere with pain signals that are being sent to the brain. The electrical impulses are generated by a small device, called a stimulator, which is implanted under the skin. The stimulator is connected to leads (wires) that are placed next to the spinal cord. The electrical impulses can be controlled and are usually barely noticeable.

Benefits of Spinal Cord Stimulation

If you suffer from chronic pain, you know how draining it will make you feel. You may have tried numerous treatments with little to no relief. Spinal cord stimulation (SCS) is a treatment that has helped many people find relief from chronic pain.

There are many benefits of SCS. It is a safe and effective treatment option with fewer side effects. It can also be reversible, so if you do not get relief from your pain, the stimulator can be removed. SCS can help to reduce or eliminate your use of pain medications by providing lasting pain relief.

SCS is an individualized treatment that is tailored to each person’s needs. The strength and frequency of the electrical impulses can be adjusted to provide the maximum benefit with the least amount of discomfort. Most people who have SCS report significant reductions in their pain levels and improvements in their quality of life.

Who is the right candidate for Spinal Cord Stimulation

If you suffer from chronic pain, you may be wondering if spinal cord stimulation is right for you. This treatment is not right for everyone, but it can be very effective for certain types of chronic pain. A physiatrist, neurosurgeon, or pain specialist will determine the treatment options by assessing your physical condition, symptoms, and pain history for considerable improvements. Here are some things your doctor will consider when deciding if spinal cord stimulation is right for you:

  • Your pain should be constant, and not just occasional. Spinal cord stimulation is most effective for people who have constant, chronic pain.
  • Do not want to undergo surgery because of the costs and long recovery time.
  • Other Treatment options have shown no major effects. Spinal cord stimulation is used as a last resort after other treatments, such as physical therapy, medication, and surgery, have failed to provide relief.
  • Your pain should be originating from the spine. This treatment is most effective for people whose pain is originating from the spine, such as those with degenerative disc disease or spinal stenosis disorders.

If you think that spinal cord stimulation might be right for your symptoms and conditions then talk to your doctor about it. This treatment can provide significant relief for many people suffering from chronic pain in the spine.

How is the procedure performed?

You will lie on your stomach after receiving light anesthesia. Affected areas of the back are prepared for the procedure. The electrode leads are inserted in the affected area of the back with the help of fluoroscopy. A skinny insertion is made in the back and a portion of the bony arch is removed for lead placement. The leads touch the epidural space above the spinal cords. It does not directly touch the spinal cord. Modern SCS devices can be used for positioning leads based on anatomy or electric monitoring of nerves. If the leads are implanted well in the trial then there is no need for repositioning of leads. Once the leads are in place a wire is passed from the spine to the buttock for generator implantation. A skin incision is made beneath the waistline for placing the pulse generator. It creates a pocket where the lead wire can be attached to the pulse generator. This helps in positioning of generator within the skin pocket. The incisions are closed with sutures and skin glue. A dressing is then applied after suturing.

Recovery 

There are no serious side effects after the procedure. You may experience a slight pain in the area where the wires and simulators were inserted. Your doctor will prescribe pain relievers to subdue the pain. After around 10 days you have to visit your healthcare provider to get your incisions checked. Other minor complications you may notice are infection, bleeding, injury, migration, or wire breakage.

Risks and Side Effects

Every procedure comes with risks and side effects. Specific complications related to spinal cord stimulation includes –

  • infection, bleeding, nerve damage, tingling or numbness in the treated area, and pain at the implant site. 
  • Cerebrospinal fluid leak
  • Lead migration
  • Allergic reactions
  • Paralysis or weakness
  • Epidural hemorrhage, hematoma, or spinal cord compression.
  • Stimulation changes such as cellular changes in electrodes, change in electrode position, loose electrical connections, and lead failure.
  • Skin erosion and generator migration

There is also a risk of additional nerve damage if there is movement during surgery or if too much current is delivered during treatment. Additionally, as with any medical procedure, there is always a risk of complications associated due to anesthesia or other medications used during surgery. 

Summary

If you’re considering spinal cord stimulation for your chronic pain management needs, it’s important to talk with your doctor about any potential risks and side effects beforehand so that you can make an informed decision about whether this treatment option is right for you.