Spinal cord stimulators (SCS) are a specific type of neurostimulator, a medical device designed to modulate neural activity by delivering electrical impulses to specific parts of the nervous system. Spinal cord stimulators work to manage chronic pain by sending electrical impulses to the spinal cord. These devices are implanted in the body and help to mask pain signals before they reach the brain. By doing so, spinal cord stimulators can significantly improve the quality of life for patients suffering from chronic pain or neuropathic pain conditions that have not responded to other treatments.
Video: Dr. Alexander Hersel on Spinal Cord Stimulation
Symptoms Indicating the Need for Spinal Cord Stimulation
The primary symptom that might indicate the need for spinal cord stimulation is chronic pain that has not responded to conservative treatments such as physical therapy, medications, or injections. Other symptoms include:
- Persistent and severe back pain or leg pain.
- Neuropathic pain characterized by burning, tingling, or shooting sensations.
- Reduced mobility due to pain.
- Pain that interferes with daily activities and significantly impacts quality of life.
What Conditions can be Treated with Spinal Cord Stimulation?
Spinal cord stimulators are typically considered for patients who experience chronic pain that is neuropathic in nature, meaning it stems from nerve damage or dysfunction. Some of the most common conditions that may warrant the use of a spinal cord stimulator include:
- Failed Back Surgery Syndrome: Persistent back pain after one or more back surgeries.
- Complex Regional Pain Syndrome: A chronic pain condition usually affecting the limbs after an injury or surgery.
- Peripheral Neuropathy: Damage to peripheral nerves, often resulting in pain and numbness in the extremities.
- Arachnoiditis: Inflammation of the arachnoid lining surrounding the brain and spinal cord, causing severe pain.
- Sciatica: Pain radiating along the sciatic nerve, which runs down one or both legs from the lower back.
- Angina and Peripheral Vascular Disease: In some cases, SCS can be used for these conditions to alleviate pain when other treatments have failed.
Spinal Cord Stimulators Treatment and Recovery
- Evaluation and Trial Period: Before a permanent spinal cord stimulator is implanted, patients typically undergo a trial period. During this time, a temporary device is placed to assess the effectiveness of the stimulation. This trial usually lasts about a week and helps determine if the patient experiences significant pain relief.
- Permanent Implantation: If the trial is successful, a permanent spinal cord stimulator is implanted. The procedure is usually done on an outpatient basis and involves the following steps:
- Placement of Leads: Electrodes (leads) are placed in the epidural space of the spinal cord.
- Implantation of the Pulse Generator: A small device, similar to a pacemaker, is implanted under the skin, typically in the abdomen or buttock.
- Connecting the System: The leads are connected to the pulse generator, and the system is programmed to deliver electrical impulses to the spinal cord.
- Post-Operative Care: After the surgery, patients are typically monitored for a short period before being discharged. The initial recovery period includes:
- Pain Management: Mild pain and discomfort around the incision sites can be managed with medications.
- Activity Restrictions: Patients are advised to avoid strenuous activities and heavy lifting for several weeks.
- Follow-Up Visits: Regular follow-up visits are essential to monitor the patient's progress and adjust the device settings for optimal pain relief.
- Long-Term Recovery and Management:
- Device Adjustments: The device settings may need to be fine-tuned over time to achieve the best pain relief.
- Physical Therapy: Patients may benefit from physical therapy to improve strength and flexibility.
- Lifestyle Modifications: Maintaining a healthy lifestyle, including a balanced diet and regular exercise, can enhance the overall effectiveness of the spinal cord stimulator.
