Spinal cord stimulation is a procedure that blocks pain signals from reaching the brain. A tiny device provides electrical pulses to the spinal cord, just like a pacemaker. This device helps individuals manage their chronic pain better and lower their use of any treatments.
If you suffer chronic arm, leg, or back pain and haven’t found relief with other medications, this might be an option.
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Spinal Cord Stimulator
An SCS device (Spinal Cord Stimulator) is attached surgically under the skin. This device will send a minor electric current to the spinal cord. The pulse generator will create mild current and will then send it to the spinal cord’s nerve fibers with the use of thin wires.
The SCS stimulates the nerves in the location where you feel the pain whenever you turn on the device. Since the electrical pulses change and block the pain signal from reaching the brain, pain is lowered.
Keep in mind that this therapy does not get rid of the pain source. It just blocks the signal from reaching the brain. Thus, the amount of pain relief depends on one individual to another. In addition to that, several patients find it unpleasant when they feel a tingling sensation.
Because of this, before the device is implanted permanently, a medical professional will do trial stimulation. The objective of this therapy is to reduce 50% up to 70% of the pain. But, if it helps you to lowers the amount of pain medication you take and do your day-to-day activities with less pain, even a tiny amount of pain reduction can be huge. Keep in mind that this procedure doesn’t work for everybody.
The device can be unattached if the therapy isn’t successful. It will not damage the nerves or the spinal cord.
To replace the pain sensation with paresthesia (a minor tingling feeling), Several SCS devices utilize a low-frequency current.
Other SCS devices utilize burst pulses or high-frequency to cover the pain without any tingling sensation. On almost every device, there is an option for a paresthesia-free setting.
As we have mentioned, this procedure doesn’t get rid of the source of pain. It just alters the way our brain perceives the pain. In addition to that, SCS doesn’t boost muscle strength.
There are a few kinds of SCS device systems. But, every single one of them includes 3 primary components:
- A hand-held remote control that turns the device off and on and regulates the settings.
- A lead wire with around 8 up to 32 electrodes that send electrical pulses to the spinal cord.
- A pulse generator with a battery that generates the electrical pulses.
Depending on the frequency of use, if a device does not include a rechargeable battery, it has to be replaced surgically every 2 up to 5 years. Rechargeable battery devices might last 7 up to 11 years. However, you should remember to charge the device every day.
The pulse generator includes a setting that can be programmed. Several SCS devices are able to know a change in body position, such as lying down or sitting.
They also adjust the level of stimulation to your activity. On the other hand, there are several systems that include leads that you can program independently to cover several areas in your body. Of course, a medical professional will chose the ideal type of device for you.
Who Should Avail This?
To determine whether your goals of pain management are suitable for Spinal Cord Stimulation, an assessment of your pain history, medication regime, and physical condition will be performed. A pain specialist, a physiatrist, or a neurosurgeon will examine all past surgeries and treatments.
Since chronic pain also includes emotional effects, a psychologist will check your condition to maximize the possibility of an effective result.
Typically, a person chosen for Spinal Cord Stimulation has had chronic weakening pain for 4 months or more in the arm, leg (sciatica), or lower back. Usually, they also have had 1 or more spinal surgeries.
You might be a candidate for Spinal Cord Stimulation if:
- You’ve had an effective SCS trial.
- You’ve got no medical conditions that will keep you from undergoing surgery.
- You don’t have an untreated drug addiction or depression. Prior to having a Spinal Cord Stimulation, these must be treated.
- You don’t want further surgery since you’re afraid of the long recovery or the risks. SCS might often be recommended over a complicated and huge spine surgery.
- The pain is a result of a correctable issue and should be fixed.
- You won’t benefit from extra surgery.
- Conservative therapies have failed.
You’ll come to your medical professional around 10 days after surgery to have the incision examined. Bring your product box and device remote to your follow-up appointment with the medical professional. If required, programming of the pulse generator can be changed during this meeting.
It’s crucial to work with your medical professional to change your medications and improve the stimulator’s programming.
To do fine-tune changes to your Spinal Cord Stimulator, your device representative and pain specialist will work with you.
What are the Outcomes?
The outcomes of SCS vary on patient education, proper surgical technique, effective trial stimulation, and careful patient selection. Stimulation doesn’t eliminate the condition that’s causing the pain. Instead, it helps the person to handle the pain. If pain is lowered by at least 50%, the Spinal Cord Stimulation is considered effective.
What are the Risks?
Just like any surgeries, this procedure also comes with several risks. General problems of any surgery include reactions to anesthesia, blood clots, infection, and bleeding. Certain issues related to Spinal Cord Stimulation might include:
- Pain, numbness, clumsiness, weakness, or paralysis below the level of implantation.
- Generator migration or/and local skin erosion.
- Allergic response to implant materials.
- Lead migration. This can result in a reduction in pain relief and changes in stimulation.
- A seroma (pocket of clear fluid) might appear at the implant area. Typically, this disappears by itself. However, it might require a drain.
- Persistent pain at the stimulator or electrode area.
- Cerebrospinal fluid leak
- Battery leakage and/or failure.
- Paralysis, spinal cord compression, infection, hematoma, and/or epidural hemorrhage. This can be a result of placing a lead in the epidural area during a surgical procedure.
- Undesirable changes in stimulation. It can potentially be associated with cellular alterations in the tissue around electrodes, lead failure, loose electrical connections, and/or changes in electrode position.
Issues for which you may require extra surgery include mechanical failure of the device (rare case), breakage of the extension wire or lead, or movement of the lead. Reasons for removal of the SCS device include failure to relieve pain and infection.
Scar tissue often develops around the electrode and can make the stimulation less successful.
Before surgery, you might be scheduled for several tests. This includes chest X-ray, electrocardiogram, and blood test. You’ll sign forms, such as consent forms, in the doctor’s office so that the surgeon understands your medical history. This includes past surgeries, anesthesia reactions, bleeding history, vitamins/medicines, and allergies.
Inform your medical professional about all the medications you’re taking. This includes herbal supplements, prescription, and over-the-counter medications. Always follow what your medical professional suggests you. This will help improve the effectiveness of your Spinal Cord Stimulation.