Have you ever wondered the next therapy for a patient who isn’t responding to any of the pain management approach?. Well, there is a therapy known as Spinal Cord Stimulation. Spinal cord stimulation (SCS) is a relatively new technology that can help manage chronic pain when the cause cannot be removed or the injury cannot be repaired. The device consists of a stimulating wire or “electrode” or connected to control unit or “generator.” By placing a stimulating electrode over the spinal cord, the pain signal cannot be sent up from the spine to the brain.
After a patient has been evaluated and non-surgical treatments have been used, spinal cord stimulation is considered to help manage chronic pain. A patient will often undergo mental health testing and counseling so they understand how an implanted device will be managed. A trial is done by placing one or two wires into the space outside the spinal cord and controlling them from a unit outside of the patient’s body. This is usually kept in place for about a week and the patient is able to test how well stimulation through the wire helps their pain. The stimulation is a very mild electrical pulse that the patient usually does not feel. These electrical pulses mask the pain signal and can be adjusted over the course of the trial to get the greatest improvement in pain. Trials are considered successful if they can remove half of a patient’s pain.
A successful trial is then followed by surgery to place a permanent stimulator. This is usually done by making a small cut in the back and another near the waist. A small, flat electrode or wire is placed through the incision on the back to the space behind the spinal cord. The wire is then tunneled under the skin to the incision near the waist where it is connected to a small battery powered generator. The generator is placed under the skin at the waist incision. The system is tested and if all is found to be working properly, the incisions are closed and the surgery is finished. The stimulator is controlled with a small hand-held remote, which can be used to make adjustments as needed. Some generators’ batteries need to be recharged every few days and some don’t need to be recharged at all. Those that are not rechargeable usually need to be replaced about every 3-5 years while rechargeable batteries can last for more than 10-15 years.
