Spinal Cord Stimulation Therapy

Back pain can be a debilitating and often hard-to-treat condition which affects nearly a quarter of adults, according to the Centers for Disease Control and Prevention. Acute back pain may last a few days to weeks while chronic back pain persists for more than 3 months. A nerve modulation technique, known as spinal cord stimulation therapy, is a standard treatment option for chronic back pain sufferers unable to resolve their condition with other types of treatment.

Spinal Cord Stimulation

Spinal cord stimulation, SCS, also known as dorsal column stimulator, DCS, therapy is a type of surgical procedure to relieve back pain or pain emanating from the back to the arms and legs. It uses a small, implantable device to deliver low-voltage electrical stimulation to spinal nerves. This blocks but does not cure pain signals from reaching the brain and being sensed by the patient. It is designed for individuals who have been unsuccessful in previous attempts at relieving pain.

Device and Procedure

The medical device used in spinal cord stimulation therapy consists of a lead wire with four to 16 electrodes that deliver an electric current, which is connected to a pulse generator or power source, according to the MayfieldClinic website. The lead wire with electrodes is implanted in the epidural space of the spinal cord while the pulse generator is placed under the skin in the abdomen or buttocks region.
An external, handheld remote control gives patients control of impulse strength and timing. Before permanent placement of an SCS device, trial leads are placed and connected to an external power source to determine the effectiveness of the device in alleviating pain. If successful, surgery is typically performed on an outpatient basis by a pain specialist or surgeon, using local anesthesia to place a permanent lead wire and general anesthesia to place the impulse generator. Individuals can return to normal activity in approximately 2 months.

Advantages

Along with providing relief from back pain as a spinal cord stimulator is designed to do, there are many benefits with this type of therapy. Implantation is a minimally invasive surgery and completely reversible if unsuccessful at alleviating pain. Pain relief is in the hands of the patient as he is able to control stimulation with the external control device. Individuals can return to a normal life, even swimming, as the electrical leads are implanted below the skin. If pain reduction is successful, many patients with a SCS are able to reduce or eliminate pain medications as well.

Risks

As with all surgical procedures, risks should be explained and understood. Some of these risks would be bleeding, infection and adverse reactions to anesthesia -- to more specific complications of spinal cord stimulation therapy. Of particular importance is that SCS therapy does not provide full relief of pain in all individuals, with approximately 40 to 70 percent of patients achieving long-term relief of pain.
There is a risk of nontarget stimulation by the implanted device, such as around the chest and rib area; overstimulation may lead to unpleasant sensations or motor impairment. There is a risk of spinal fluid leakage or persistent pain at the implant site. A statistical product control, SPC, may also work intermittently, experience battery failure or migrate to undesirable locations resulting in the need for additional surgeries to remove or replace the device.

Spinal Cord Stimulation Therapy