Spinal Cord Stimulation

What Is Spinal Cord Stimulation?

Spinal cord stimulation (SCS) is a therapy that uses electrical impulses to interrupt pain signals before they reach the brain. A small device similar to a pacemaker is implanted under the skin, connected to thin wires (leads) placed near the spinal cord. It's typically considered when other treatments haven't provided adequate relief.¹

How It Works²

• Electrical impulses modify pain signals
• Traditional SCS creates tingling (paresthesia)
• Newer systems work without tingling
• Different waveforms and frequencies available
• Patient controls stimulation level
• Can be turned on/off as needed

Conditions Treated

• Failed back surgery syndrome
• Complex regional pain syndrome (CRPS)
• Chronic radicular pain
• Peripheral neuropathy
• Angina (refractory)
• Some types of nerve damage

The Trial Period³

• Temporary leads placed first
• External device worn for 5-7 days
• Tests effectiveness before permanent implant
• 50% or greater pain relief = successful trial
• Helps predict long-term success

Permanent Implant

• Surgical procedure (usually outpatient)
• Generator placed under skin (abdomen or buttock)
• Leads positioned in epidural space
• Programming session after healing
• Multiple programming options

Types of SCS

• Traditional low-frequency
• High-frequency (10 kHz)
• Burst stimulation
• Dorsal root ganglion (DRG) stimulation
• Each has different characteristics

Benefits

• Can significantly reduce pain
• May decrease medication use
• Improves function in many
• Reversible (can be removed)
• Adjustable to changing needs

Risks and Considerations

• Infection
• Lead migration
• Hardware failure
• Need for revisions
• MRI compatibility varies by device
• Battery replacement needed
• Not effective for everyone

Living with SCS

• Regular follow-up appointments
• Avoid certain activities initially
• Carry device ID card
• Inform medical providers
• Security screening considerations

References

1. Deer TR, Mekhail N, Provenzano D, et al. The appropriate use of neurostimulation of the spinal cord and peripheral nervous system. Neuromodulation. 2014;17(6):515-550.
2. Verrills P, Sinclair C, Barnard A. A review of spinal cord stimulation systems for chronic pain. J Pain Res. 2016;9:481-492.
3. Kumar K, Hunter G, Demeria D. Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery. 2006;58(3):481-496.