More About Spinal Cord Stimulation
DescriptionSpinal cord stimulation (SCS), also called neurostimulation, disrupts the electrical signals that travel between the nerves of the body up the spinal cord to the brain. This disruption in the dorsal column of the spinal cord interrupts these signals as they travel to the brain, which theoretically should result in less perceived pain by the individual. This medical technology has been utilized for approximately 60 years. SCS is done with an electronic medical device that uses special wires called “leads,” which are placed into the epidural space adjacent to the dorsal column of the spinal cord. The neurostimulator device has many ways of sending out signals to disrupt the pain signals traveling up to the brain; some ways that are not overtly noticeable, others that work in a fashion that may cause a slight tingling sensation that the individual may perceive. The device is completely controlled by you, allowing complete adjustment of the level of stimulation: ON --> OFF --> UP --> DOWN in intensity.
Appropriate Conditions for SCS
- Failed back/neck surgical syndromes
- Radicular extremity pain
- Degenerative disc disease (non-operative)
- Sympathetically mediated pain (Complex Regional Pain Syndrome, Reflex Sympathetic Dystrophy)
- Refractory angina
- Peripheral vascular disease
Patient Selection The best candidates for neurostimulation using SCS therapy are patients living with chronic, intractable, nerve related pain after they have “failed” conservative therapy (physical therapy, osteopathic manipulation/chiropractic care, acupuncture, medications, injections or surgeries, etc.). You often have an “overactive” nervous system that has many irritated nerves that inappropriately fire electrical impulses to the brain despite any significant injurious pathology.
The Goals of SCS Therapy
- Improve quality of life
- Improve pain relief
- Better ability to walk/perform ADLs/exercise in ways realistic for the individual
- Improve the side effects of living with a chronic illness (potentially fewer medications)
- Improve sleep
Four Step Process of SCS Therapy
- An initial educational class led by a nurse practitioner at the spine & pain management center and attended by a medical device rep.
- Psychological evaluation by a licensed psychologist.
- The five to seven day trial period or what could be thought of the SCS “test-drive” period.
- The permanent implantation of the SCS device by a surgeon in the operating room.