FAQ’s on Spinal Cord Stimulator Implants in Philadelphia

Spinal cord stimulation (SCS) is a safe, reversible way of managing certain types of chronic pain that do not respond to other treatment measures. According to the National Institutes of Health (NIH), chronic pain is more common than heart disease, diabetes, and cancer.

How common is chronic pain?

The Institute of Medicine reports that around 115 million people in the U.S. suffer from a chronic pain condition. This is around 18% of all citizens. According to one study, half of people suffering with chronic pain are unable to work because of their condition.

What type of pain responds to spinal cord stimulation?

Chronic, intractable pain responds well to SCS. This pain is often from a neuropathic origin. Lesions of the peripheral or central nervous system cause dysfunction, which results in chronic neuropathic pain. This type of pain is often associated with damage from injury to nerves or an inflammatory response.

What conditions respond to spinal cord stimulation?

  • Spinal stenosis – This is narrowing of the spinal canal, which irritates nerves. Patients often have leg numbness, weakness, along with back pain.
  • Failed back surgery syndrome – This results from continued pain after back surgery, usually due to scar tissue developing around nerves. Patients often have a continuous, aching pain with this problem.
  • Neuropathies – These conditions occur from degeneration or damage of the peripheral nerves. Symptoms include pain, sensory difficulties, motor insufficiencies, and bone degeneration.
  • Phantom limb pain – After an amputation, the patient may continue to perceive pain in the area where the limb once was. This is related to nerve damage.
  • Post-herpetic neuralgia – This pain is due to complications from shingles. The nerves are damaged and continued pain occurs in the area where the rash occurred.

How does the spinal cord stimulator work?

The spinal cord stimulator delivers mild electrical impulses to the epidural space near the spinal cord. The electrical impulses override pain signals to the brain, which decreases sensation of pain.

How do I prepare for the SCS procedure?

You should discuss your medications with the pain management specialist, as blood-thinning agents must be held for several days. You cannot eat or drink after midnight before the procedure, but necessary medications are to be taken with sips of water. Leave all valuables at home, and arrange for someone to drive you from the hospital.

How is the SCS procedure performed?

Usually, general anesthesia is used for this procedure. The doctor will cleanse the surgical areas with an anesthetic and use a local anesthetic to numb the skin and deeper tissues. Small incisions are made along the middle of the back to implant the electrodes. The stimulator is implanted under the skin of the lower abdomen or buttocks. Wires run from the small unit and connect to an electrode surgically implanted near the spinal cord. Proper placement is ensured by use of fluoroscopy (x-ray guidance). Once the devices are surgically implanted, the incisions are closed with sutures, and bandages are applied.

What can I expect after the SCS procedure?

You will be monitored in a recovery area for 30-45 minutes. It may be necessary for you to stay overnight at the hospital.

What risks are associated with the SCS?

The spinal cord stimulator implantation procedure carries a few risks, although they are rare. These include spinal fluid lead, scar tissue formation around the device or wires, numbness, weakness, paralysis, pain at the incision site, battery failure, bleeding, allergic reaction, and blood vessel injury.

Is the spinal cord stimulator effective?

Clinical studies show that the success rate is around 85-90%. One study found that the procedure more effective for pain management when the device was implanted within two years from the initial onset of pain.

 

Resources

Bendersky D, Tampolsky. Is spinal cord stimulation safe? A review of its complications. World Neurosurg. Sept 2013;18:1-10.

Deer TR, Skaribas IM, Haider N, et al. (2010). Effectiveness of Cervical Spinal Cord Stimulation for the Management of Chronic Pain. J International Neuromodulation Soc.

Frey ME, Manchikanti L, Benyamin RM, Schultz DM, Smith HS, Cohen SP. Spinal cord stimulation for patients with failed back surgery syndrome: a systematic review. Pain physician. 2009;12(2):379-397.

Simpson EL, Duenas A, Holmes MW, Papaioannou D, Chilcott J. Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation. Health Technology Assessment.2009;13(17):1-154.