A Shock to Your System: What is Spinal Cord Stimulation?
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What is Spinal Cord Stimulation? What Does SCS Involve?
Spinal Cord Stimulation (SCS) is a leading form of neuromodulation that seeks to improve certain types of chronic pain associated with the spinal cord. This therapy involves the surgical implantation of a device called a generator beneath the skin, as well as the winding of flexible electrode strips along target nerves of the spinal cord. The generator essentially acts as the brain of the stimulating system by monitoring activity of these target nerves and sending safe, electrical impulses whenever the nerves are active. The electrode strips deliver these electric impulses to the target neurons, interrupting the signal being sent along them. In many patients suffering from chronic pain of their spinal cord, this system seeks to significantly reduce the frequency of pain signals traveling along damaged or overactive nerves.
This technology has been improved for over 50 years and has provided significant improvements to the lives of patients with chronic pain that qualifies for treatment. Spinal cord stimulation treatment typically requires a patient having attempted and seen minimal success with other interventional pain management treatments. Examples include epidural steroid injections, nerve blocks, and radiofrequency ablation procedures. Each of these, which seek to silence target nerves in their own respective ways, may sometimes only offer temporary relief, if any, for certain patients. In such cases, qualifying patients may consider spinal cord stimulator device implantation.
It is common for patients to rely on opioids if they have found nothing other than short-term success when treating their chronic pain. This is an unfortunate reality because opioids carry heavy risks and side effects. Evidence of this is seen from the opioid epidemic that is responsible for over 930,000 lives being lost to opioid-related drug overdose since 1999. Today, over 3 million individuals in the United States struggle or have struggled with opioid addiction. Spinal cord stimulation offers a promising alternative to many of these individuals who may qualify; in fact, over 60% of individuals once dependent on opioids have reported reduced or completely halted usage following implantation of a spinal cord stimulator.
Who Might Benefit from Spinal Cord Stimulation?
It is no mystery that chronic pain is the symptom of various conditions, so whether a patient qualifies for spinal cord stimulation will be a very personalized outcome. There are a number of conditions that tend to see success with spinal cord stimulation. Having one of the listed conditions does not guarantee someone is a good candidate; conversely, not having one of these conditions does not disqualify someone from being a good candidate. Ideally, though, the following list will help you understand if spinal cord stimulation is a good option for individuals similarly experiencing chronic pain of the back, neck, or limbs:
- Failed Back Syndrome and Failed Back Surgery Syndrome
- Radiculopathy, Herniations, and Injuries of the Spinal Cord
- Degenerative Disk Disease (DDD)
- Causalgia or Peripheral Causalgia
- Peripheral Vascular Disease
- Complex Regional Pain Syndrome (CRPS)
- Diabetic Neuropathy and Other Nerve-Related Pain
- Epidural Fibrosis
- Arachnoiditis
- Cancer-Related Pain
- Amputation-Related Pain
- Various Other Conditions, Ailments, and Origins of Pain!
How Do I Get Started?
As previously mentioned, the implantation of a spinal cord stimulator is a surgical operation. Though surgery is often a last-resort option (and this should still be pursued with prior vetting of other, less-invasive options first), spinal cord stimulation may be a much more appealing choice to certain intensive surgeries. If you wish to get started on this journey, the first of two general steps is to start with a trial-run.
- A spinal cord stimulator trial is a less-invasive, non-surgical approach to finding out if the device is truly right for you! This trial is typically 7-days long and involves the winding of the electrodes along your target nerves, but does not involve the more-invasive implantation of the generator. Instead, the brain of the device will be sealed to the outside of your body while you see how the device works at reducing your chronic pain over the next week. Configuration of the device and its settings to your specific needs is always done by a trained representative of the medical device. Representatives often come from very well known companies such as Boston Scientific and Nevro, both of whom make premier spinal cord stimulation devices.
- After the 7-day trial period has ended and a patient has had time to experience what the device could offer for them in the long-term, a decision is then reached. Typically, at least 50% reduction of pain must be observed for an individual to qualify and proceed to the surgical implantation. The surgery lasts for an average of two hours. The first part involves the placement of the electrodes along the target nerve(s). This part of the surgery is nearly identical to what occurs in the trial procedure. The second part of the procedure involves the implantation of the generator right beneath the skin of the buttock or abdomen. This is different from the trial in that the generator is now inside the body as well.
How Successful is Spinal Cord Stimulation?
Spinal Cord Stimulation has seen great success in treating patients, especially as the technology has become more and more advanced over the past 50 years. Today, approximately 47% to 74% of individuals who receive an SCS implantation will see long-term improvement to their chronic pain and functionality.
Here at Ospina Medical, our doctors are trained in the placing of electrodes during the spinal cord stimulator trial. Book your appointment today with Dr. Matthew Kohler or Dr. Raj Maniam to get started with this process!
Author: Camden Rowe