SPINAL CORD SIMULATION
Spinal cord stimulation (SCS) is indicated for patients who have been diagnosed with complex regional pain syndrome, post-laminectomy pain syndrome, or lumbar radiculopathy. Complex regional pain syndrome is a disorder where the patient exhibits pain, swelling, limitations of range of motion and changes to the skin and/or bones. Post-laminectomy pain syndrome is a term for patients who have had previous spine surgery but continue to have significant pain. There are several advantages to using this minimally invasive therapy including: adjustable and targeted pain relief, cost-effectiveness, and limited side effects.
Spinal cord stimulation works by placing soft lead wires in the epidural space. These leads produce mild electrical signals, which alters the pain processing of the central nervous system. Evidence shows that SCS alters the local neurochemistry in dorsal horn, suppressing the hyperexcitability of the neurons. Ultimately, this should reduce the patient’s experience of pain.
The process of obtaining the spinal cord stimulation is done in 2 steps. First, the stimulator leads are placed temporarily for a 1 week trial period. During this week, the patient is asked to record improvement of pain and activity levels. If the patient reports good improvement, they are deemed to be an appropriate candidate for implantation.
The spinal cord stimulator implant is an outpatient procedure, where a small battery device is placed- usually in the flank. This is connected to the soft leads and are then permanently set. Typically, this device lasts approximately 8-10 years. If it is no longer desired, the device can always be removed.
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