What are Spinal Cord Stimulators?
Spinal Cord Stimulators (SCS) are implantable devices that deliver mild electrical impulses to the nerves along the spinal cord. These impulses interfere with the transmission of pain signals to the brain, effectively reducing or eliminating the sensation of pain in the targeted area. Spinal cord stimulator devices consist of electrodes placed near the spinal cord and a small battery-powered generator implanted under the skin, typically in the lower back or buttocks.
When Can Spinal Cord Stimulators Be Used?
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Failed Back Surgery Syndrome (FBSS): For patients who continue to experience chronic pain following back surgery, SCS can offer significant relief by disrupting pain signals before they reach the brain.
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Neuropathic Pain: SCS is effective in managing neuropathic pain conditions such as complex regional pain syndrome (CRPS), diabetic neuropathy, and peripheral neuropathy, providing relief where traditional treatments may have been unsuccessful.
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Low Back Pain: For patietns with low back pain not related to arthritis, spinal cord stimulator may be beneficial
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Leg Pain: Patients suffering from chronic leg pain due to conditions like peripheral vascular disease or lumbar spinal stenosis may find relief with SCS, allowing them to experience improved mobility and quality of life.
What to Expect During an SCS Trial
How is a Spinal Cord Stimulator SCS Placed?
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There are two phases of SCS placement:​​
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Spinal Cord Stimulator Trial: SCS trial leads are placed in the pain clinic inserted through a needle to just next to the nerves of the spine. This is done with local anesthesia, and typically take about 30 minutes to perform. The leads are attached to a pulse generator and the SCS is "trialed" for 5-7 days. Then the leads are easily removed in the clinic.
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Spinal Cord Stimulator Implant: If there is significant reduction in pain during the trial, the a permanent placement of SCS system should be considered. This is a minor surgery that permanently implants the system under the skin.
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What are the risks of the Spinal Cord Stimulator Trial?
As with most procedures, there is rare risk of bleeding, infection, nerve injury or allergic reaction to the medications used. Some short-term side effects may occur.
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you may have weakness or numbness that can last for several hours. If this happens you may have to stay in the clinic until this resolves.
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You may have localized pain at the insertion site for 1-3 days
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The procedure cannot be performed if you have an active infection, flu, cold, fever, or very high blood pressure. For your safety, please make your doctor aware of any of these conditions.
Will the spinal cord stimulator stimulator placement hurt a lot?
Most people say the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure, although every person's response to any procedure is individual. When the spinal cord stimulator leads are inserted you may experience temporary discomfort in your back or legs.
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What happens during the actual procedure? After you sign a consent form and your blood pressure is checked,
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The procedure will be done in the fluoroscopy (x-ray) room with you lying on your stomach.
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The back is cleansed with an antiseptic solution and sterile drapes are placed.
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The skin is anesthetized (numbed) with a local anesthetic. This is felt as a stinging or burning sensation.
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Using x-ray guidance, a needle is then advanced into the epidural space. Once the needles are in the proper location, the spinal cord stimulator lead is inserted to the appropriate level needed to cover your pain.
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The procedure is then typically repeated, as two SCS leads are usually placed for the trial
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Once placed, the spinal cord stimulator leads are attached to the pulse generator/battery and that is sutured and taped to the skin.
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After the procedure and once you are in the recovery area, the representative from the stimulator company will test and program the system to get optimal coverage of your painful areas.
How will I feel after the spinal cord stimulator is placed?
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You will likely have some short-term discomfort at the insertion site the next day
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It can take 2-3 days before the effect of the SCS is felt
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the trial typically will last 5-7 days, then the leads will be removed in the office with minimal, if any, discomfort
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Will I have any restrictions during the SCS trial?​
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You should not drive for the remainder of the day after your procedure. An adult must be present to drive you home or to go with you in a taxi or on public transportation.
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For your safety, the procedure will be cancelled if you do not have a responsible adult with you.
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You may eat, drink and take your medications as usual on the day of the procedure (both before and after).
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You cannot shower or submerge the area in water during the trial--sponge baths are ok.
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There will be some limitations on your activities which we will discuss before you leave the clinic
Please follow these instructions unless told differently by your doctor.
For what reasons should I call? If you experience severe back pain, new numbness or weakness of your legs, or signs of infection in the area of the injection, you should call the office.