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SPINAL CORD STIMULATION

Spinal Cord Stimulation

What is Spinal Cord Stimulation?

Spinal Cord Stimulation is a procedure we perform in order to alleviate chronic neck and back pain as well as nerve pain in the arms and legs.  It is like a TENS unit except it is placed inside the spine instead of on the outside of the skin. This procedure can significantly improve chronic neck and back pain as well as nerve pain (sharp, shooting, burning, tingling, stabbing, numbness) in the arms and legs.  For Thoracic SCS, this can potentially help pain and numbness from the mid back all the way down to the feet.

HOW IS THE PROCEDURE PERFORMED?

This procedure consists of 2 parts. A test that lasts 5-7 days and then an implant. For the test/trial, Our doctor will numb the back and then insert a thin electrode into the epidural space of the spine. That electrode is connected to a battery on the outside of your skin with a sterile dressing applied over it. The battery sends an electrical signal to the spinal cord that disguises the pain signal going to the brain.

We then program your stimulator to make sure it covers areas of pain.  We will give you a controller that allows you turn the stimulator off/on and you will have the ability to change the settings as well.  We will have someone contact you every day during this trial to check on you and help make any adjustments to your stimulator that may be needed to ensure maximum pain relief.  They will also be in contact with our doctor every day during the trial.

After 5-7 days of the trial, we bring you back in and we will remove the trial leads.  This procedure is extremely effective.  If your trial is successful (relieves the majority of your pain), we then send you to a surgeon for part 2 which is the implant.  This is a minimally invasive surgery.  The surgeon will place the electrical leads similar to our doctor, however, the main difference is that instead of the battery being on the outside of the skin, the surgeon makes a small incision in the love handle area and places the battery a few centimeters beneath the skin.    This is an outpatient surgery so you are in and out same day.  Pain recovery time is minimal compared to most back surgeries.

What Medical Indications Are Indicated For Spinal Cord Stimulation?

  • Cervical Postlaminectomy Pain Syndrome (neck pain persisting well after cervical spine sugery)
  • Thoracic Postlaminectomy Pain Syndrome (thoracic pain persisting well after thoracic spine sugery)
  • Lumbar Postlaminectomy Pain Syndrome (low back pain persisting well after lumbar spine sugery)
  • Cervical Radiculopathy (pinched nerve in the neck causing radiating pain and /or numbness down the arm)
  • Thoracic Radiculopathy (pinched nerve in the mid back causing radiating pain and /or numbness across the torso)
  • Lumbar Radiculopathy/Sciatica (pinched nerve in the lower back causing radiating pain and /or numbness down the leg)
  • Complex Regional Pain Syndrome (CRPS) also known as Reflex Sympathetic Dystrophy (RSD)
  • Diabetic Peripheral Neuropathy (peripheral nerve pain in the hands or feet)
  • Injured Nerve after Surgery (injured nerve after a surgery such as hip, knee, ankle/foot, hand and other surgeries)
  • Phantom Pain (nerve pain after limb amputation)

Benefits of New SCS technology

  • New technology (burst stim) is so much better than the old (tonic stim).
  • The battery we use in the new technology does not have to be recharged and typically lasts about 5-10 years.  When that battery does eventually wear out, the surgeon simply changes the battery but does not have to do anything to the wire electrodes so you are in and out quickly for that procedure.
  • The new batteries are MRI compatible.
  • You will have the ability to update your battery just like an app so you can get any new updates that come out in the future.
  • In the past, some patient’s developed tolerance/habituation with the old SCS battery technology after 3-5 years because it would stimulate constantly at a high frequency and the body would get use to it.  With the new battery technology, SCS stimulates at a low frequency so that most patients don’t even notice the stimulation and we usually set it to stimulate for 30 seconds on and 90 seconds off.  This still covers your pain for that 2 minute duration, even during the 90 seconds it is off.  By taking this break, it helps prevent tolerance from developing so that the stimulator is less likely to lose its ability to help over time.