Spinal Cord Stimulation
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Spinal cord stimulation (SCS) is a technique that treats pain using a mild electric current to block nerve impulses in the spine. A small wire in the epidural space (the area between the vertebrae and the covering of the spinal cord) connects to a battery-powered generator, implanted beneath the skin. This technology can be programmed to maximize pain relief.
To see if this interventional therapy is likely to help your pain, University of Maryland Pain Management specialists first conduct a trial with a device that stays outside your body and connects to a wire in the epidural area. If your pain improves during this three to five day test period, a generator can be implanted in another procedure.
While some generators’ batteries are rechargeable, others last two to five years after which you will need another surgery to replace the battery.
Conditions Spinal Cord Stimulation Treat
UM Pain specialists may recommend this therapy if other treatments such as physical therapy, medications or less invasive procedures have not helped. These conditions are among those that may respond to spinal cord stimulation:
- Back pain that continues or gets worse, even after surgery to correct it
- Complex regional pain syndrome (CRPS)
- Long-term (chronic) back pain
- Nerve pain or numbness in the arms or legs
- Stump Pain
Patient Information: Spinal Cord Stimulation
How do I prepare for the procedures?
Your medical team will provide full instructions for how to prepare for this procedure. This will include when you can eat prior to the procedure and what medications you can and cannot take. If you are diabetic, pregnant or taking blood thinners, such as Coumadin (warfarin) or Plavix, let your doctor know.
You should arrange to have someone drive you home from the procedure.
What happens during the trial procedure?
During the one-hour trial procedure, we will numb your skin with a local anesthetic, and place the wires in the epidural space. They connect to a small current generator outside of your body that you carry like a cell phone. You can go home after the procedure.
What happens during the implantation?
During the implantation, which takes about one to two hours, you will be under general anesthesia. We will insert the generator under the skin of your abdomen or buttocks through a small surgical cut.
What happens after the implantation?
You will remain in the recovery area about 30–60 minutes while we monitor your vital signs. A representative from the device-maker will assist in setting up your stimulator and review the instructions for use. You receive verbal and written discharge instructions and may go home with your driver after your doctor authorizes discharge.
What are the risks of spinal cord stimulation?
As with most procedures, there is a risk of bleeding, infection or allergic reaction to the medications used. Some mild short-term side effects include headache, nausea or dizziness. Rare brain or nervous system complications can occur.
Specific risks of spinal cord stimulator trial and implantation include:
- Cerebrospinal fluid (CSF) leakage
- Damage to the nerves that come out of the spine, causing paralysis, weakness, or pain that does not go away
- Infection of the battery or electrode site (if this occurs, the hardware usually needs to be removed)
- Movement of or damage to the generator or leads that requires more surgery
- Pain after surgery
- Problems with how the stimulator works, such as sending too strong of a signal, stopping and starting, or sending a weak signal
- The stimulator may not work
The SCS device may interfere with other devices, such as pacemakers and defibrillators. After receiving the SCS, you may not be able to get an MRI anymore.