Spinal cord stimulation is a therapy that uses a small device to interfere with pain signals before they reach the brain. This pacemaker-like device—the spinal cord simulator or SCS—is implanted in the body and sends electrical pulses to the spinal cord. This helps patients better manage their pain and can be especially helpful for people dealing with chronic back, leg or arm pain.
Stimulation does not work for everyone, the amount of pain relief varies and some people may find the sensation unpleasant. Because of this, a trial stimulation must be performed before the SCS is implanted permanently.
There are different types of SCS programming options, and your physician will recommend one or more of these.
Some systems use non-rechargeable batteries. These must be surgically replaced every two to five years. Others use rechargeable batteries and can last eight to 10 years, but must be charged every day.
Finally, it’s helpful to know that every SCS has three main parts:
- Pulse generator with a battery
- Lead wire with electrodes that delivers electrical current
- Remote control to activate the device and adjust settings
Preparing for the Procedure
You should not to eat or drink for at least six hours before your scheduled procedure. Small sips of water are allowed if you need to take medications.
You should allow several hours total for your appointment. This time includes registration, physician consultation and examination, the procedure and recovery time. You will also spend about 30 minutes with a programmer from the manufacturer to help you better manage your stimulator. You cannot drive yourself home after the procedure, so make arrangements for a friend or family member to take you home.
Note: If you take any type of blood-thinning or diabetic medication, it’s important that you notify us before your procedure and will give you instructions about what you need to do.
What Happens During the Procedure?
The SCS trial happens in two phases: first, the lead wire must be placed in the epidural space of your spine. Once that phase is completed, the lead wire will be attached to a temporary programming box (the size of a mobile phone).
Your physician will use a type of “real time” X-ray tool called a fluoroscope to insert the electrode leads.
Next, your physician will ask you how well the stimulation is affecting your pain. He or she will try several different stimulation settings and you will report on any tingling you feel. These settings will be used to program the pulse generator. Once programming is complete, you will be transferred to the recovery area where further instruction with you and your driver will occur.
What Happens After the Procedure?
During the trial week, you should relax the first 24 hours. After that, you should try to slowly increase your level of activity on a daily basis. You should keep a log of what helps and what hurts. This information will be invaluable when discussing its effectiveness with your physician or your programming specialist.
Once you are home, you do not need to restrict your activities. However, you should rest and avoid anything strenuous. You should not drive for at least eight hours.
What Are the Outcomes of the Procedure?
Spinal cord stimulation does not eliminate pain, but can reduce it. Many patients experience a 50 to 70 percent reduction in their pain. If the trial produces this kind of pain relief and you agree, we will refer you back to your referring physician or another expert in permanent placement for your permanent SCS.