Spinal Cord Stimulation

Spinal Cord Stimulation

What is Spinal Cord Stimulation?

Spinal cord stimulation (SCS) consists of stimulating electrodes, implanted in the epidural space, an electrical pulse generator, implanted in the lower abdominal area or gluteal region, conducting wires connecting the electrodes to the generator, and the generator remote control.

SCS is analgesia on demand and is a useful option when other forms of therapy fail. It reduces pain medication and side effects and is effective in about 50–70% cases. It is an invasive procedure, so it can have associated complications.

Indications

SCS has notable analgesic properties and is used mostly in the treatment of

  • Failed back surgery syndrome (FBSS)
  • Peripheral neuropathic pain - including groin and knee pain
  • Complex Regional Pain Syndrome
  • Peripheral ischaemic pain.

FBSS, classified as mixed pain syndrome (neuropathic and nociceptive), is the persistent or recurrent pain, mainly involving the lower back and/or legs after successful spinal surgery. It affects about 40% of patients who undergo spinal surgeries.

SCS can also be indicated in the treatment of inoperable ischemic limb pain.

Is it right for me?

You will need to be assessed by a Consultant in Pain Management specifically trained in SCS implantation. You would be fully counselled in the requirements of the device and its implications to yourself as an individual using a multidisciplinary team including a Clinical Nurse Specialist and a Clinical psychologist.

There are different types and modes of stimulation available and the appropriate type and mode is decided on each individual’s requirements.

How is it implanted?

SCS procedure involves careful placement of electrodes in the epidural space, a trial period (which takes between 7-14 days), and, if the results of pain relieving was satisfactory in the trial period, anchoring the electrodes to the ligaments beneath the skin alongside the spine, positioning and implantation of the pulse generator, tunneling and connection of the connecting wires, programming the system for the special pattern of stimulation and associated postoperative follow up.

Complications

The most common complications include lead migration, lead breakage, and infection. Other complications include haematomas (subcutaneous or epidural), cerebrospinal fluid (CSF) leak, post dural puncture headache, discomfort at pulse generator site, seroma and transient paraplegia.

This information was provided to Spencer Private Hospitals by Pain Management Specialist, Dr Neil Collighan who performs this procedure.

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