What is a Spinal Cord Stimulator?
A spinal cord stimulator is an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain.
Spinal cord stimulators consist of thin wires (the electrodes) and a small, pacemaker-like battery pack (the generator). The electrodes are placed between the spinal cord and the vertebrae (the epidural space), and the generator is placed under the skin, usually near the buttocks or abdomen. Spinal cord stimulators allow patients to send the electrical impulses using a remote control when they feel pain. Both the remote control and its antenna are outside the body.
Why might I need a Spinal Cord Stimulator?
SCS is an innovative technology that targets some of the most difficult pain problems a person can be challenged with. This technology has given patients a second chance to experience a normal pain free life, resuming everyday activities, without many restrictions or pain related worry.
SCS might be the right treatment for a number of conditions, including:
Back pain, especially back pain that continues even after surgery (failed back surgery syndrome)
Injuries to the spinal cord
Radiculopathy – pain that progresses down your arms/hands or legs/feet
Degenerative Disc Disease
Peripheral vascular disease
Pain after an amputation
Visceral abdominal pain and perineal pain
What happens during the procedure?
Spinal cord stimulators require two procedures to test and implant the device: the trial and the implantation.
Spinal Cord Stimulator Trial
The first step is a trial period. The surgeon will implant a temporary device for you to test out. Guided by a specific type of X-ray, surgeon will carefully insert the electrodes in the epidural space of the spine. The location of your pain affects where these electrodes will be placed along the spine. Your surgeon may ask for your feedback during the procedure to best position the electrodes.
This trial procedure typically requires only one incision in your lower back to place the electrodes. The generator/battery will be outside the body, typically on a belt, you’ll wear around your waist.
For about a week, you will evaluate how well the device reduces your pain. The trial is considered a success if you experience a 50% or greater reduction in pain level.
If unsuccessful, the wires can easily be removed in the clinic without damage to the spinal cord or nerves. If successful, surgery is scheduled to permanently implant the device.
Spinal Cord Stimulator Implantation
During the permanent implantation procedure, the generator is placed underneath the skin and the trial electrodes are replaced with sterile electrodes. Unlike the trial electrodes, these will be anchored by sutures to minimize movement.
The implantation can take about 1-2 hours and is typically performed as an outpatient procedure.
After the local anesthesia has been administered, your surgeon will make one incision (typically along your lower abdomen or buttocks) to hold the generator and another incision (along your spine) to insert the permanent electrodes. The incisions are about the length of a driver’s license. As in the trial procedure, x-ray is used to determine where the electrodes are placed.
Once the electrodes and generator are connected and running, your surgeon will close the incisions.
Your surgeon may provide sedation to keep you comfortable and ask for your feedback during placement of the electrodes.
What happens after the procedure?
You will wake up in the recovery area. Your blood pressure, heart rate, and respiration will be monitored, and your pain will be addressed. Most patients are discharged home the same day or the following morning. The pulse generator will be programmed before you leave. You will be given written instructions to follow when you go home.