Pain felt in or around your spine results from nerve impulses sent from the affected part of your backbone to your brain.
What spinal cord stimulation (SCS) does is interrupt this transmission of nerve signals. It’s a pain management option that may be suggested if you haven’t had success with medication, physical therapy, epidural injections, or similar pain management and treatment efforts. If SCS is effective, you may benefit from noticeable improvements to your daily quality of life.
What Is Spinal Cord Stimulation?
Spinal cord stimulation is designed to mask pain by disrupting signals before they get to the brain. SCS won’t treat the source of your symptoms, but it could result in improvements with how you manage pain. It involves the use of an implantable device, called a spinal cord stimulator, which delivers a mild electric current to your spinal cord. Small wires transmit this current to the affected area. The goal with SCS is 70 to 90 percent pain reduction.
Who May Benefit from SCS?
Spinal cord stimulation is intended for individuals with nerve-based spine pain that’s not manageable with other treatment efforts. You may also benefit from SCS if you sustained a personal or work-related injury that’s largely aggravated by nerve irritation. This may include sciatica linked to disc herniation or nerve compression. SCS may also help patients with spine-related discomfort related to:
- Spinal stenosis
- Blood vessel disease
- Complex regional pain syndrome
- Pain that lingers after back surgery
- Spinal nerve inflammation and scarring (arachnoiditis)
What Is a Spinal Cord Stimulation ‘Test Drive’?
Before a spinal cord stimulator is implanted under your skin, you’ll have a chance to “test drive” it. This means a needle will be inserted into the epidural space around the spinal cord. The distribution of current will be handled by an external generator that’s worn on a belt around your waist. The trial period lasts for about a week.
How Is Permanent/Long-Term Placement Done?
If you have a more than 50 percent reduction in pain during the trial period, surgical implantation will be discussed. Prior to surgery, you’ll go through standard pre-surgery tests. Image tests may also be done to determine if there are sources of your symptoms that may need to be addressed.
After you are given light anesthesia, the electrode leads are inserted with visual guidance from a special type of live X-ray (fluoroscopy). A small part of a bony covering is removed with a procedure called a laminotomy to provide sufficient space for the leads. Sutures hold the leads in place, although they will not directly touch your spinal cord.
The spinal cord stimulator (generator) is then implanted. You may be awakened so that settings can be adjusted. The wire is inserted under the skin near your spine to your buttock. This is where the generator is implanted. It will be properly positioned in the skin pocket before the incision is closed. During your follow-up appointment, adjustments can be made to the stimulator.
Once your device is programmed, you’ll be able to control the settings yourself based on your personal preferences and level of pain experienced. Being less distracted by spine pain could also make it easier to get regular exercise, participate in PT sessions, and take other steps to manage your discomfort as you resume your regular routine or perform your work-related tasks. The device and its related wires can be removed if there are issues.