Spinal cord stimulation (SCS) is an innovative technology based on very old theory of sensory stimulation that been used to control pain thousands of years ago. Ancient Egyptians may have used electrogenic fish 4500 years ago applying the same concept. Now, we have so many clinical studies and firm data to support the effectiveness and the benefits of Spinal Cord Stimulation in lots of painful conditions.
Simply, the Spinal cord stimulation (SCS), consists of electrical energy producing electrodes placed in the epidural space, and connected to electrical pulse generator that transmits signals to dorsal part of the spinal cord, interrupting pain signals from reaching the brain.
SCS has notable analgesic properties and is used mostly in the treatment of failed back surgery syndrome, complex regional pain syndrome and refractory pain due to ischemia.
SCS is also used for neuropathic pain, including Diabetic Neuropathy, Spinal Stenosis, Chronic Radiculopathy, and is identified as an effective treatment option for many chronic pain sufferers.
How SCS works?
Spinal cord stimulation provides pain relief by transmitting very precisely measured electrical impulses to the spinal cord. The SCS signals passes through the same pathway that pain signals go through, this way the SCS signals block the pain transmission to reach the brain. The pain sensation now is substituted by a pleasant sensation that can differ from patient to patient, but it is always a pleasant sensation that is very well liked by most of the patients.
How SCS is tried?
When SCS is scheduled for a trial, a SCS lead is introduced into the epidural space under Fluoroscopic (X-Ray) guidance. The specific level of the spinal cord at which the lead is placed inside the epidural space will depend on where you feel pain.
Usually SCS trial lead placement, is as simple as an Epidural Injection, the only difference is that it is done under different sterile preparation that takes most of the procedure time.
After successful placement is confirmed, the trial lead is secured in place using a sterile tape, and attached to an external pulse generator that gets programed in recovery to make sure that you are comfortable with the SCS coverage. Once connected, the system generates mild electrical pulses that will be programmed to replace your areas of intense pain with the more pleasant sensation, aka paresthesia.
The doctor will determine with you the length of the trial period, usually from 4 days to no later than a week. The trial period is like a test drive, you get to try it out through your regular daily activities, mainly the ones that you were unable to engage in because of the pain. By programing the battery remote control, you will be able to control the simulation strength, area of coverage, different programing sensation, turning it on and off…and lots of other pleasant features that helps you control your pain.
If your trial is successful, you and your doctor agreed that you are going to benefit from the SCS system, placement of a permanent SCS system will be arranged.
How the SCS implant is different from the trial?
Pain control wise, shouldn’t be any difference at all, and that is why we did the trial in the first place. The only difference is the surgical aspect of the procedure, the implant is usually done under deeper sedation or general anesthesia and takes longer time than the trial, usually around one hour to one hour and a half.
The SCS system implant means that the whole system (leads and battery) will be placed under the skin so there will be nothing coming out of your body.
The battery will be the most superficial part of the system in order to be charged and programed when needed, and it is roughly around the size of an “Oreo” cookie. There are multiple areas of the body where the battery can be placed, it is discussed with the doctor and it is usually determined based on your preference.
The battery is charged by placing the charger over the area where the battery is implanted, and is controlled by a remote control to turn the device on/off, adjusting intensity, changing programs to change how it feels making sure you are getting the most pain control out of it. Implantable systems like the SCS, makes it possible to resume most of your normal life and recreational activities without limitations.
SCS also enables many people to reduce or eliminate the use of pain medications. Keep in mind that even though an SCS system is called permanent, it is a reversible therapy. If treatment should no longer be needed, the implanted parts can be easily removed.
How Long does the Procedure Take?
Both procedures are done on an outpatient basis. The SCS trial procedure takes approximately 30 to 45 minutes including the preparation time, the SCS implant takes two hours at most, both are followed by a short period in recovery.
What are the Expected Results?
SCS for some patient is a turning point, specially the patients that had a long history of nerves related pain. Success rate depends a lot on the patient selection and setting up the right expectations from this procedure. While the degree of pain relief varies from person to person, based on studies, more than 80 percent of patients undergone treatment report a 50 to 70 percent reduction in improvement in their pain. The pain relief is reflected in so many aspects of their lives, like being able to engage back in work and family family activities normally again.
And in turn, controlling your pain is reflected on your mental well being, stress level and ultimately improving the overall quality of life.
If you suffer from chronic pain that is due to spine or disc diseases, following back or neck surgeries, spinal stenosis or any other nerves related pain, spinal cord stimulation (SCS) may enable you to control and relieve your pain.
Schedule your appointment today and discuss it in more details with your doctor