OrthoNeuroSpine & Pain Institute
What Are Spinal Cord Stimulators?
Spinal cord stimulators are implanted neurostimulation devices that are similar in function and appearance to cardiac pacemakers, except that the electrical pulses are sent to the spinal cord instead of the heart. These “pacemakers for pain” interrupt the pain signals’ pathways to the brain by delivering low intensity electrical pulses to trigger selective nerve fibers along the spinal cord. Researchers theorize that stimulating these nerve fibers diminishes or blocks the intensity of the pain message being transmitted to the brain, replacing feelings of pain with a more pleasant tingling sensation called paresthesia.
A spinal cord stimulation system includes:
Neurostimulator or generator—a surgically implanted, battery-operated medical device that is like a pacemaker for pain
Leads—one or more thin wires with several electrodes or contacts that carry mild electrical pulses from the neurostimulator to specific segments of the spinal cord
Patient controller—a remote control device that turns the system on and off and allows patients to adjust stimulation within parameters set by physicians
Programmer—a device that enables the doctor or clinician to adjust and fine-tune the stimulation programs
To have a spinal cord stimulator implanted, a patient undergoes a minor surgical procedure in which a lead or leads are placed in the epidural space next to the spine. Leads are positioned using a small needle or by making an incision and they are then connected to the generator, which serves as the power source. Once activated, the system’s programs are adjusted and fine-tuned to best control the patient’s pain. Patients use a controller that allows them to check the system’s battery, adjust the stimulation level, select from pre-set programs, and turn the system power on and off.
Spinal Cord Stimulation Overview
Spinal cord stimulation (SCS) devices are a method of pain control for the treatment of chronic pain of the arms, legs and trunk, or pain resulting from failed back surgery. Although it is not a cure, SCS therapy can be successful in reducing pain that is the result of dysfunction or damage to the nervous system caused by injury, disease or localized trauma. Chronic pain is a largely under-treated and misunderstood disease that affects millions of people worldwide. It is defined as moderate to severe pain that persists for three or more months longer than would generally be expected for recovery to a specific disease, injury or surgery.
Neurostimulation studies have shown that SCS systems can often reduce pain by 50 percent or greater. These patients are often able to reduce or eliminate their use of pain medications, such as analgesic opioids, which potentially have negative side effects, including dependency. By providing significant pain relief, SCS therapy enables many patients to increase their activity levels and improve their overall quality of life.
Patients should always be encouraged to talk with their physicians or seek out pain management practitioners if they believe they are suffering from chronic pain.
Indications for Use: Chronic, intractable pain of the trunk and limbs.
Contraindications: Demand-type cardiac pacemakers, patients who are unable to operate the system or who fail to receive effective pain relief during trial stimulation.
Warnings/Precautions: Diathermy therapy, cardioverter defibrillators, magnetic resonance imaging (MRI), explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, postural changes, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.
Adverse Events: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis).