If you suffer from chronic back pain or even arm or leg pain, you may benefit from spinal cord stimulation (SCS) therapy. This treatment reduces your pain by preventing pain signals from the spine from reaching the brain. This is achieved using an SCS device that operates similarly to a pacemaker. The device sends nerve blocks through mild electrical pulses to the spine.
If you are considering having spine surgery to get a spinal cord stimulator implant, this article will help you gain a better understanding of whether you are a candidate for surgery. We will also review the process leading up to surgery, the surgical procedure, and what to expect during recovery.
What is a Spinal Cord Stimulator?
A spinal cord stimulator is a device surgically placed between the vertebrae and the spinal cord. This area is in the epidural space where nerve roots are located. As previously mentioned, the SCS relieves pain by creating nerve blocks from mild electrical pulses.
There are several different SCS devices:
- Those with a battery that can only be surgically replaced. These need to be replaced every 2-5 years.
- Those with rechargeable batteries. These need to be replaced every 8-10 years, but the system requires a daily recharge.
- Those that operate through radiofrequency from outside the body (these are less common).
All spinal cord stimulators have the same primary components that make up the device.
Why is the Procedure Performed?
There are several reasons patients may be advised to undergo a spinal cord stimulation procedure:
- To deal with chronic pain that affects the arms or legs due to complex regional pain syndrome (CRPS).
- To deal with back pain that is either long-term or has continued even after surgery.
- To deal with nerve pain, numbness, and tingling in the arms or legs and reduce swelling around nerves, joints, meninges, and spinal cord.
SCS is a procedure usually recommended after taking other measures to deal with persistent pain. By reducing their pain through surgery, patients can experience better mobility and less need for pain medication. Overall they experience a greatly improved quality of life.
Who is a Candidate for Spinal Cord Stimulation?
Pain specialists are the ones who determine if patients may be candidates for spinal cord stimulation. Those experiencing severe, chronic, and debilitating pain may be considered, for example, patients with conditions such as degenerative disc disease, regional pain syndrome, severe diabetic neuropathy, etc.
There is a list of criteria patients must meet to become a candidate. They must be 18, able to use the system, have pain rooted in physical ailments rather than psychological ones, and successfully complete a trial period of SCS. Other factors considered include physical health and history.
What Happens Before Surgery?
Part of the process of determining your candidacy will depend upon the successful completion of a trial period. The trial should help lessen your pain by at least 50%.
To initiate a trial, a patient will undergo a procedure that involves the following steps:
- Local anesthesia will be applied to the injection site.
- Wire leads are inserted through an epidural needle or small incision into the epidural space. These leads are connected to an external trial stimulator.
- Electrodes at the end of the lead create mild electrical pulses that block the nerves and prevent pain signals from being delivered to the brain.
- The patient provides feedback for the doctor to locate the best area for the stimulators to provide maximum pain relief.
- The patient will use the external stimulator for about one week, after which the physician will remove the wire leads.
The patient and doctor will collaborate to determine if the amount of pain relief experienced during the trial warrants permanently implanting an SCS device.
What Happens During Surgery?
The spinal cord stimulation procedure to permanently implant the device will occur while the patient is sedated or under general anesthesia. Similarly to the trial, permanent wire leads are inserted through an epidural needle or small incision into the predetermined location. Then a small incision is created, usually in the abdomen or buttocks, and the IPG battery is placed beneath the skin. The wire leads are then connected to the battery.
The patient will be given an external wireless programmer to power the device on and off and adjust the stimulator settings.
What Happens After Surgery?
After the procedure, the incision site may be slightly swollen and sore for several days. Patients must ensure they regularly clean it and keep an eye out for infection. A good amount of rest and limited activity for the first few weeks following surgery is crucial for proper healing. Normal activities may be resumed after the first couple of months.
It is also essential to attend regular follow-ups with a doctor. Physical therapy may be recommended for recovery.
Work With a Pain Management Specialist in Arizona
At Arizona Pain and Spine Institute, our team of pain specialists is here to provide you with the medical advice and procedures you need to experience lasting relief.
If you are experiencing chronic pain that has been resistant to other measures and treatments, it may be time to consider a spinal cord stimulation procedure. Contact us today to start your journey to a better quality of life!