Spinal Cord Stimulation

By Reza Ghorbani, MD, FIPP

Spinal cord stimulation (SCS) devices are approved by the U.S. Food and Drug Administration (FDA) as a method of pain control for the treatment of chronic pain of the arms, legs and trunk, or pain resulting from failed back surgery.
In their search for relief, pain patients often endure inadequate treatments and struggle with prescription painkillers.
Neurostimulation studies have shown that SCS systems can often reduce pain by 50% or greater. These patients are often able to reduce or eliminate their use of pain medications, such as analgesic opioids, which potentially have negative side effects, including dependency. By providing significant pain relief, SCS therapy enables many patients to increase their activity levels and improve their overall quality of life.
What Are Spinal
Cord Stimulators?
Spinal cord stimulators are implanted neurostimulation devices that are similar in function and appearance to cardiac pacemakers, except that the electrical pulses are sent to the spinal cord instead of the heart. These “pacemakers for pain” interrupt the pain signals pathways to the brain by delivering low intensity electrical pulses to trigger selective nerve fibers along the spinal cord. Researchers theorize that stimulating these nerve fibers diminishes or blocks the intensity of the pain message being transmitted to the brain, replacing feelings of pain with a more pleasant tingling sensation called paresthesia.
A spinal cord stimulation system includes
Neurostimulator or generator – a surgically implanted, battery-operated medical device that is like a pacemaker for pain
Leads – one or more thin wires with several electrodes or contacts that carry mild electrical pulses from the neurostimulator to specific segments of the spinal cord
Patient controller – a remote control device that turns the system on and off and allows patients to adjust stimulation within parameters set by physicians
Programmer – a device that enables the doctor or clinician to adjust and fine-tune the stimulation programs
To have a spinal cord stimulator implanted, a patient undergoes a minor surgical procedure in which a lead or leads are placed in the epidural space next to the spine. Leads are positioned using a small needle or by making an incision and they are then connected to the generator, which serves as the power source. Once activated, the systems programs are adjusted and fine-tuned to best control the patients pain. Patients use a controller that allows them to check the systems battery, adjust the stimulation level, select from pre-set programs, and turn the system power on and off.
Patients should always be encouraged to talk with their physicians or seek out pain management practitioners if they believe they are suffering from chronic pain.