Spinal Cord Stimulation

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Spinal cord stimulation sends mild electrical impulses to the spinal cord which interrupts the pain signals to the brain, replacing them with a tingling sensation. These electrical impulses are generated by a small device placed below the patient’s skin. 
Spinal cord stimulation is done to provide relief to patients from chronic pain due to several conditions including failed back surgery, neuropathy, and complex regional pain syndrome. The spinal cord stimulation process improves the overall quality of life, and sleep and reduces the need for medications.

The treatment procedure for Spinal Cord Stimulation

Before implanting a permanent stimulator, a trial stimulator is inserted for a prior of around 5- 7 days. During the trial implantation of the device, the patient is given local anesthesia to numb the area and sedation to keep the patient relaxed. Insulated wires called leads are placed through the needle carefully in the epidural area, adjacent to the spine. Then these wires are connected to a stimulator that remains outside the body for the duration of the trial. The leads are removed from the skin at the end of the trial without causing much pain or discomfort. If the device is proven to be successful to relieve the pain and the patient can bear the tingling sensation it provides, then the patient is ready for a permanent implantation procedure.
For the permanent implantation procedure, an incision is made at the back to place the leads underneath the skin of the patient, and another incision is made to permanently implant the stimulator under the skin, usually in the buttocks or the abdomen.
The simulator is not visible under the skin and has a rechargeable battery that lasts for around 5 to 10 years depending on its usage and the model of the device.

Recovery from the Spinal cord stimulation

This is a minor procedure and, in most cases, patients are advised to stay in the hospital for overnight to examine any kind of unbearable pain or any other issues. The main problem faced by the patients after the procedure is pain for a few days at the area where the wire and stimulator are inserted for which the doctor will prescribe some pain relief medications. Other complications include infection, bleeding, nerve damage, spinal cord injury, dural tear or dural puncture, or breakage of the wires.
The patients are recommended to restrict heavy lifting and other strength activities for around 4-6 weeks to let the leads heal without moving from the appropriate position.

Complications of the Spinal cord Stimulation

The complications associated with spinal cord stimulators are rare but no procedure is completely safe. A small fraction of patients may experience-
  • Bleeding 
  • Infection 
  • The device might shift from its appropriate place and the stimulator might not block the pain effectively
  • Device damage
  • Spinal cord trauma may cause injury and paralysis
  • Dural puncture

If you have been recommended to go for Spinal cord stimulation by your doctor, then  get a second opinion from another neurosurgeon to be well informed about all the risks involved and other options available.

Frequently Asked Questions

Spinal cord stimulation is an implantable device that delivers mild electrical impulses to the spinal cord to interrupt pain signals before they reach the brain. It is used for chronic back and leg pain (failed back surgery syndrome), complex regional pain syndrome (CRPS), and neuropathic pain conditions that have not responded to other treatments.

Yes. SCS is particularly effective for neuropathic leg pain (sciatica) and failed back surgery syndrome (FBSS)a condition where pain persists or returns after spine surgery. Success rates for SCS in these conditions are 50–70%, with many patients achieving >50% pain reduction and significant improvement in quality of life.

Yes. Before permanent SCS implantation, a trial stimulation period of 5–7 days is performed where temporary leads are placed and connected to an external device. If the patient experiences >50% pain reduction during the trial, permanent implantation is recommended. This trial ensures the treatment is effective before committing to the device.