Spinal cord stimulation for pain

Spinal cord stimulation uses a set of electrodes that are implanted on the surface of the spinal cord, typically in the thoracic region. Spinal cord stimulation is often used to treat back and lower extremity pain (pain below the waist), although sometimes it can be used in the neck or cervical spine to treat neck or arm pain. Spinal cord stimulation is similar to the TENS (transcutaneous electrical nerve stimulation) units used externally for pain management, but offers stronger pain relief.
 
Before a spinal cord stimulation procedure is performed on an individual, he or she will first undergo a trial procedure. The trial procedure is performed on an outpatient basis and entails a wire being threaded into the spine under X-ray guidance. The wire is connected to an external pulse generator, and the trial stimulator can be tested out at home for about a week. If it successfully provides pain relief, a permanent spinal cord stimulator can be implanted. The final procedure will take place in an operating room and will install permanent wires that are connected to a small battery-like device, similar to a pacemaker that is implanted under the skin.

Spinal cord stimulation modulates the pain pathways running through the spinal cord up to the brain, disrupting the pain signals being sent to the brain and offering pain relief. It is typically used on people who experience “failed back syndrome”—those who have had back surgeries and have tried other treatments (physical therapy, steroid injections, etc.) that have failed to provide pain relief. People who have chronic regional pain syndrome (also known as regional sympathetic dystrophy [RFD] or cervicalgia), which often develops as the result of trauma to a specific area of the body, are also good candidates for spinal cord stimulation.

We believe in offering our patients a range of options to treat pain, from noninvasive options to advanced surgical procedures. Our expert team can help each person decide if spinal cord stimulation is the right choice to manage his or her pain. Our neurosurgeons work closely with pain management doctors to ensure that spinal cord stimulation is the right fit for a particular individual.  

Potential risks and complications of spinal cord stimulation include:

• Infection
• Ineffective pain relief

Those who undergo the procedure can expect to have a significant degree of pain relief following the implantation of the device. An external remote control is used to control the stimulator and adjust its settings. The batteries in the device will need to be replaced approximately every eight to nine years.