Spinal Cord Stimulator

Spinal Cord Stimulator

A spinal cord stimulator is a device that is implanted near the spinal cord to block nerve signals to your brain. This reduces pain sensations. The device can help relieve the feeling and may reduce your reliance on pain medications. The field of neuromodulation was born from the need to find an alternative to surgery. SCS trials avoid the excessive tissue injury and scarring inherent in open surgery. The important thing to remember is a SCS trial is not surgery, in fact there is no cutting of any kind. Patients get to test out the neurostimulation in a fully reversible fashion to see if it works and is effective in treating their specific pain complaints.

This information will explain what it is, Dr. Singer can determine if it is for you.

Dr. Singer uses three different companies for Spinal Cord Stimulation. Selection of which brand of SCS is best for an individual patient is based on medical history, causes of pain and physical examination. Read more about each company here:

Abbott

Medtronic

Nevro

What is a spinal cord stimulator? A spinal cord stimulator system is made of four parts:

1. Impulse Generator (IPG): this is a computer that is roughly the size of a matchbox that controls the impulses delivered to the spinal cord. It is implanted under the skin and has an inbuilt battery.
2. An electrode: this sits in the epidural space and delivers very small and precise currents to the spinal cord.
3. A hand-held controller: this is used to turn the system on and off, adjust the type of stimulation, location of stimulation and level of stimulation.
4. A hand-held charger: some IPGs are rechargeable and require regular charging to maintain stimulation.

What is spinal cord stimulation? Spinal Cord Stimulation (SCS) alters the experience of pain by sending impulses to the spinal cord that compete with pain signals. As a result, the pain messages that your body sends to the brain are blocked or modified. What conditions can SCS treat? Spinal cord stimulation is most commonly used for leg, back and arm pain that has not responded to spinal surgery. It can also be used to treat back pain that is not suitable for spinal surgery. Other conditions that may also respond to SCS include complex regional pain syndrome (CRPS), pain following nerve injury, refractory pain, post-herpetic neuralgia, diabetic neuropathy, and peripheral vascular disease. If Dr. Singer decides that this treatment is suitable for your condition, a comprehensive trial is undertaken to determine if SCS will be helpful to you. There are many different spinal cord stimulator devices available for the management of chronic pain. Dr. Singer will determine the appropriate spinal cord stimulator for you, by assessing you independently and using up-to-date clinical research and current best practice.

What happens during a SCS trial? After changing into a hospital gown, you will be taken to the procedure room in a wheelchair. You will lay on your stomach on the procedure table during the procedure. Sedative medication will be given to reduce discomfort, so you must have a driver to take you home and monitor you after the procedure. If you do not, we cannot proceed with the trial that day. After administering local anesthetic, a specialized needle is used to enter the epidural space which lies underneath the bones of the vertebrae. Two thin stimulator leads (electrodes) are then advanced in the epidural space to a specific level of the spine. When the stimulator is positioned correctly, it will be secured to the skin and covered with a dressing. This will remain in place for the duration of the trial. Throughout the trial period different modes of stimulation may be used to confirm the effectiveness of this treatment in your specific case. You will be required to follow up with the technician for your device throughout the trial period of 7-10 days. Throughout the trial period it is important that you follow the restrictions given to you by the device representative, Total Body Pain Institute nursing staff and Dr. Singer. It is also important that you communicate with the staff that are monitoring you to determine the effectiveness of the SCS over the course of the trial period. At the completion of the trial, the leads will be removed, and a decision will be made whether to proceed to permanent implant.

What happens after the trial procedure? You will be assisted in getting redressed and our staff will escort you to your ride. While the trial leads are in place, you are not permitted to shower, bath, soak in a hot tub or overexert yourself. In light of these restrictions, please remember to shower the morning of your procedure and to ensure you have assistance at home for at least the first few days following your trial lead placement. Should the tape securing your trial leads come loose, you will need to contact the office for guidance. You may feel sore for one to four days. This is most likely from the placement of the specialized needle used to guide the leads into place. You may have a headache. Following a successful SCS trial, Dr. Singer will perform the SCS implant to ensure continuity of care.

Placement of the SCS: The permanent implant is a minimally invasive surgical procedure done under anesthesia. The permanent leads are placed into your spine at the appropriate location for addressing your pain. The generator device that sends the electrical charge is then surgically placed in either your abdomen, lower back, or an area agreed upon with Dr. Singer. Dr. Singer recommends minimal activity for up to three weeks after your implant to give the incision and the leads time to heal.

This information is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.