Spinal Cord Stimulation (SCS)
Candidates for Spinal Cord Stimulation
Not everyone is a candidate for SCS. It is an option only for those who have tried, but been unsuccessful with, conservative treatments; will likely not be helped by surgery; are not addicted to drugs; have been psychologically evaluated; do not have pacemakers; and have undergone trials with an external spinal-cord stimulator.
The Spinal-Cord-Stimulation Implantation Process
Implantation of a spinal cord stimulator is a two-step process that involves first implanting the stimulator, and then a pulse generator to power it. To implant the stimulator, an incision is made in the patient's back; the wires with electrodes on the end are fed through and positioned on the spinal cord. Exact placement depends on the area of pain.
To implant the pulse generator, an incision is made in the buttocks or abdomen, and the generator is placed between layers of skin and muscle. An extension wire is run from the spine to whichever area the generator is placed in.
Incisions are closed with either staples or sutures. The procedure takes 3 or 4 hours, and the patient usually goes home on the same day.
Recovery from the Spinal-Cord-Stimulation Implantation Process
Pain from SCS implantation is treated with prescription medication and/or over-the-counter painkillers. A patient should refrain from lifting, bending, twisting and stretching during the healing process, which can take 6 to 8 weeks.
Risks and Complications of Spinal Cord Stimulation
In addition to the risks associated with any surgical procedure, those related to SCS include spinal-fluid leakage and paralysis. Complications related specifically to the stimulator include the following:
- Device works only intermittently or stops
- Device causes over-stimulation, or unpleasant sensations
- Stimulation occurs in the wrong place
- Device causes an allergic reaction
It is also possible that the device's wires could shift or become damaged, which might require surgical intervention.
The pulse generator's battery, if it is a standard one, needs to be surgically replaced every 2 to 5 years, although there are generators that run on rechargeable batteries that can last up to 10.