Spinal Cord Stimulation (SCS) is the electrical stimulation of a precise level of the spinal cord to generate paresthesia to the area(s) the patient feels pain. Spinal Cord Stimulation is an accepted pain management treatment for certain intractable pain conditions.
Indications for spinal cord stimulation include the following:
Observing careful patient selection criteria ensures successful outcomes. Patients typically do best when most of their pain involves the limbs or lower back area. The patient will be required to have a psychological evaluation before approval for a trial to ensure that there are no contraindications for a trial or permanent implant.
The injection site is numbed using a local anesthetic. One or more insulated wire leads are inserted through an epidural needle or a needle into the space surrounding the spinal cord, called the epidural space. Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals to the brain. The patient gives feedback to help the physician determine where to place to place the stimulators to best block the patient’s pain. The lead is connected to an external trial stimulator, which will be used for three to seven days to determine if Spinal Cord Stimulation will help the patient. If the patient and physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the lead is removed.
With the proper patient selection, psychological screening for contraindications and careful use of proper lead placement to cover the painful area as much as possible at the trial phase the outcome of spinal cord stimulation can be a life changer. It can cause the pain to be controllable for the patient with programming available for different pain throughout the day if indicated. The goal is activity and functional improvement to reasonable levels determined in the initial patient evaluation process.
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