Treatment Overview
Spinal cord stimulation (SCS) is a procedure
that uses an electrical current to treat
chronic pain. A small pulse generator, implanted in
the back, sends electrical pulses to the spinal cord. These pulses interfere
with the nerve impulses that make you feel pain.
Implanting the
stimulator is typically done using a
local anesthetic and a
sedative. Your doctor usually will first insert a
trial stimulator through the skin (percutaneously) to give the treatment a
trial run. (A percutaneous stimulator tends to move from its original location,
so it is considered temporary.) If the trial is successful, your doctor can
implant a more permanent stimulator. The stimulator itself is implanted under
the skin of the belly (abdomen), and the small coated wires (leads) are
inserted under the skin to the point where they are inserted into the spinal
canal. This placement in the abdomen is a more stable, effective location.
After
this outpatient procedure is complete, you and your doctor determine the best
pulse strength. You are then told how to use the stimulator at home. A typical
schedule for spinal cord stimulation is to use it for 1 or 2 hours, 3 or 4
times a day.
When in use, the spinal cord stimulator creates a
tingling feeling, rather than the pain you have felt in the past.
What To Expect After Treatment
You will have a small incision that you
should keep clean and dry until it heals.
Why It Is Done
This treatment may be done for people
with severe, chronic pain who have:
Spinal cord stimulation is typically considered
investigational for various other conditions, including
multiple sclerosis, paraplegia, and intractable
angina.
How Well It Works
There isn't a lot of evidence to show how well spinal cord stimulation works. It seems to help certain types of chronic pain, such as failed back surgery syndrome and complex regional pain syndrome.1 Spinal cord stimulation may also help chronic low back pain.2
Some researchers have reported that
more than half of people receiving spinal cord stimulation for chronic low back and leg pain, ischemic leg pain (for example, from peripheral arterial disease), or complex regional pain syndrome have pain
reduction or relief.3
Initial pain relief is often followed by a
gradual decline in effectiveness, apparently caused by the body's increasing
tolerance to the treatment.
Risks
Possible risks related to spinal cord stimulation
include:
- Scar tissue (fibrosis) developing around the
electrode.
- Pain gradually moving beyond the reach of the nerve
stimulator.
- Breakage of an electrode or hardware failure.
- Infection.
- Leakage of spinal
fluid.
- Headache.
- Bladder problems.
- Getting
used to the stimulation, making it less effective.
People with an implanted stimulator can't have magnetic resonance imaging (MRI) tests.
What To Think About
There is still
not strong proof that spinal cord stimulation works. Better research is needed.
Treatment success varies widely and is influenced by the cause of pain.
Spinal cord stimulation may be
recommended for some people who have certain types of
chronic pain.
Most spinal
cord stimulator batteries must be replaced every 2 to 5 years.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
References
Citations
- Mailis-Gagnon A, et al. (2004). Spinal cord
stimulation for chronic pain. Cochrane Database of Systematic Reviews (3).
- Taylor RS, et al. (2005). Spinal cord stimulation for
chronic back and leg pain and failed back surgery syndrome: A systematic review
and analysis of prognostic factors. Spine, 30(1):
152–160.
- Cameron T (2004). Safety and efficacy of spinal cord
stimulation for the treatment of chronic pain: A 20-year literature review.
Journal of Neurosurgery, 100(3, Suppl Spine):
254–267.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Nancy Greenwald, MD - Physical Medicine and Rehabilitation |
|---|
| Last Revised | January 20, 2011 |
|---|
Mailis-Gagnon A, et al. (2004). Spinal cord
stimulation for chronic pain. Cochrane Database of Systematic Reviews (3).
Taylor RS, et al. (2005). Spinal cord stimulation for
chronic back and leg pain and failed back surgery syndrome: A systematic review
and analysis of prognostic factors. Spine, 30(1):
152–160.
Cameron T (2004). Safety and efficacy of spinal cord
stimulation for the treatment of chronic pain: A 20-year literature review.
Journal of Neurosurgery, 100(3, Suppl Spine):
254–267.