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Spine Q&A – Spinal Cord Stimulator Implants

May 3, 2012

Edward H. Scheid, Jr., MD, Capital Region Neurosurgery

Q. I have questions concerning spinal cord stimulator (SCS) implants.  I’ve had 2 back surgeries in the last 5 years.  First a 4 level laminectomy, L2-S1, and a 2 level fusion at the L4-5 and L5-S1 levels.  My back has been hurting pretty bad as of late.  I saw my primary last week and while he does recommend me having more surgery, he suggested I look into SCS.  Could this treatment be an option for me? 

A. Spinal Cord Stimulation (SCS) is an FDA-approved method for the treatment of chronic pain in patients for whom physical therapy, medications, prior surgeries or blocks were ineffective. SCS uses electrical impulses to relieve chronic pain in the back, arms, and legs. These impulses are believed to prevent pain signals from being received by the brain. The success rate is as high as 70% in some chronic pain conditions.

The procedure begins with a trial implantation . Trials are minimally invasive office procedures done under local anesthesia and are reversible, allowing patients to try it out for three to seven days.

If the patient and physician determine that the pain relief during the trial period is acceptable, the system can be permanently implanted. The implant’s electrical pulses are programmed with an external control unit. The patient can then use the control unit to turn the system on and off, adjust the stimulation power level, and switch between different programs.

Ideal candidates for the spinal cord stimulator procedure are those for whom standard spine surgery has failed, those who are still in pain, or those in whom further conventional surgery is not an option.  Some patients have extensive scar tissue or pain after surgery where there is not an obvious cause.  These patients tend to do best with spinal cord stimulators.  However, if there is a structural problem in your spine, it generally makes sense to have conventional spine surgery to repair the structural defect before considering a stimulator, assuming that there isn’t a contraindication to traditional spine surgery, such as severe heart disease.

 Spinal cord stimulators can be very rewarding for patient and surgeon alike.  It is an amazing thing to have a patient who has been in severe pain for years leave the office after a stimulator trial with markedly decreased pain and a smile of relief.

Originally published in the Schenectady Gazette

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