Spinal Cord Stimulation Therapy

Spinal Cord Stimulation is the most popular method today to provide relief from persistent pain. It is usually administered with the help of an internal pulse generator that comes with a battery. The system consists of the following items-

1. A pulse generator that creates the electronic pulses. It is implantable.
2. A lead with multiple electrodes that delivers the electronic pulses to the spinal cord. The number of electrodes is between 4 and 16.
3. An extension wire connects the lead to the pulse generator.
4. A hand-held remote control that is used to switch on the pulse generator and also adjust the pulses.

The pulse generator is placed below the skin of the back, near the spinal column through a small incision. No major surgery is required but local anesthesia is given. The electrodes lead to the nerve fibers of the spinal cord. The stimulator is also placed below the skin, usually in the upper buttock or the abdomen.

Through the remote control, the stimulator is activated which sends mild electric currents to the electrodes that connect to the nerve fibers creating a tingling sensation in the affected area.

The patient experiences reduction in pain when the stimulator is switched on as the electric signals interrupts the pain signals and don’t allow them to reach the brain.

Doctors generally recommend thorough checkup to determine whether a patient should undergo Spinal Cord Stimulation. The pain history is also evaluated to decide if the goals of pain management comply with the treatment. Those people who have undergone surgery but did not get relief from back pain are usually recommended to undergo SCS.

Spinal Cord Stimulation is minimally invasive, cost effective and long term treatment procedure that brings respite from chronic back pain. It is one of the most widely adopted procedures to achieve goals of pain management.

This must be clarified in the beginning that no random study has been conducted that establishes the efficacy of SCS. Most studies that have been conducted so far concentrate on the timing of intervention to determine the success rate.

As for example, if the implantation is done within 2 years of the onset of the symptoms, the success rate has been reported to be around 85% wherein the success rate is defined as equal to or more than 50% reduction in baseline pain. If the implantation delay is more than 20 years, the success rate drops to 9%. With an average wait time of 5.45 years, the success rate is reported to be around 50%.

Most patients who are considered candidates for SCS are made to undergo a trial procedure to determine to what degree the procedure can control pain. When a patient achieves the desired level of pain control, he is suggested to go for permanent implantation.