Procedures > Lower Back > Spinal Cord Stimulator Implant
A spinal cord stimulator (SCS) is an implantable device that uses electrical impulses to relieve chronic neuropathic pain in the neck, chest, back, arms and legs.
Who is a candidate?
SCS candidates are patients with:
- Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD)—A progressive disease most commonly seen in the limbs. CRPS symptoms include severe neuropathic pain, swelling and changes in the skin, nails and hair.
- Lumbar radiculopathy—Chronic low-back pain that may radiate into the buttocks and legs.
- Failed back syndrome—A condition characterized by persistent pain following following multiple treatments, from conservative to surgical treatments.
- Peripheral neuropathy—A condition caused by damage to the peripheral nerves that go from the brain and spinal cord to the arms, hands, legs and feet. Peripheral neuropathy can cause chronic pain and numbness.
- Phantom pain and residual limb pain following a limb amputation.
“Spinal cord stimulators are a novel way of helping control pain,” says pain management specialist Steve Aydin, DO. “This is an advanced option we consider only for patients whose disease is very debilitating and who haven't responded well to conservative and interventional pain management methods.”
“This is one of the most satisfying procedures I perform,” adds Sanjay Bakshi, MD. “Often, these patients have seen a number of doctors. Some have had multiple surgeries. These patients are in tremendous pain—and we really can help them.
“However, a spinal cord stimulator implant is certainly a last-resort procedure,” Dr. Bakshi notes. “It is reserved for patients who have tried all other modalities.
“The best part is that since the spinal cord stimulator trial is totally reversable,” he adds. “This is one of the few procedures where the patient gets to choose whether it is working for them before we do the permanent procedure.”
Dr. Steve Aydin and Dr. Sanjay Bakshi answer questions about spinal cord stimulator implants
What is a spinal cord stimulator?
A spinal cord stimulator is an implantable electrical device with leads placed along the back portion of the spinal cord. The device causes a sensation of tingling or vibration through the dorsal columns at the back of the spine—the area responsible for perceiving vibration, sensation, heat and temperature.
How do spinal cord stimulators relieve pain?
When someone has constant chronic pain, the body often perceives one type of sensation at a time. So if pain is being perceived, and we place a spinal cord stimulator lead on the dorsal columns and stimulate them to feel vibration, the patient will feel vibration rather than pain. In other words, the spinal cord stimulator may turn the patient's mind off from feeling the pain.
Our minds are complex, but not complex enough to feel the difference between pain and vibration being transmitted.
It's similar to when you bump your elbow—usually the first thing you instinctively do is rub it because by rubbing your elbow, you're tricking your mind into thinking it's feeling rubbing instead of pain.
How strong are the vibrations?
Some patients find the spinal cord stimulator's vibrations or tingling annoying. Fortunately, the device can be adjusted for your individual needs.
How do you determine if a spinal cord stimulator will work for a patient?
Before the spinal cord stimulator is implanted, we will conduct a week-long trial to see if the device works well for you. If you do well with the trial, we will surgically implant the device.
Once the device is implanted, how does the patient control it?
Spinal cord stimulator patients use a tiny monitor to adjust the device for the sensations they feel, where they feel them and how intensely. Patients can also turn off the device or choose intermittent vibrations.
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