Spinal Cord Stimulation (SCS)
A Spinal Cord Stimulator (SCS) is a device used to manage chronic pain.
It’s like a small gadget that sends mild electrical pulses to your spine. Tiny wires are placed near your spinal cord, carrying electrical pulses. These pulses interfere with pain signals, creating a tingling sensation that helps mask or replace the feeling of pain. It’s a way to improve how you cope with and experience pain.
It’s like a gentle buzz that tricks your brain, reducing the pain you feel. This can be a helpful option when other treatments haven’t provided enough relief, offering a way to better manage and cope with chronic pain.
Spinal cord stimulation therapy uses a small device that masks pain signals traveling up the spinal cord before they can reach the brain. Spinal cord stimulation can improve quality of life significantly and reduce dependence on pain medicines, especially opioids. It is typically used along with physical therapy, and as an invasive procedure if the patient has tried other less invasive treatments for their pain which have not helped.
The spinal stimulator lead is a thin wire that is placed through a needle in the Epidural Space. The device is placed under the skin near the Spinal Cord, and it delivers a mild electric current to block the nerve pain. A weeklong trial simulation is performed to test the device and see how much pain relief is achieved before scheduling the procedure. The stimulator is a small device that is taped to the back for the trial period. If the trial is successful, the patient can choose to get a long-lasting spinal cord stimulator implant. This device is close to the size of a pacemaker, and its effectiveness varies from person to person.
What Conditions Can It Treat?
- Post-laminectomy syndrome (failed back surgery syndrome)
- Complex Regional Pain
- Syndrome (CRPS) I & II
- Phantom limb syndrome
- End-stage peripheral vascular disease
- Post-herpetic neuralgia
- Incomplete spinal cord injury
- Plexopathy
- Lumbosacral arachnoiditis
Patient Outcomes : Insights from Dr. Gupta
Spinal cord stimulator/Neuromodulation is one of many interventions utilized by Pain management physicians to help the patients suffering from severe low back and leg pain. Some of the common complications related to surgery include infection revision surgery for lead migration, dural puncture post dural puncture headache. At Kansas Pain Management we believe in patient outcomes and minimizing surgical complications.
At Kansas Pain Management we track patient outcomes. Dr Gupta has conducted multiple Studies to look at patient outcomes and improving surgical techniques.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7878096/
In the above article, Dr Gupta has discussed his surgical technique and how he was successfully able to decrease the rate of lead migration by improvising surgical technique. He has also discussed the rate of lead migration as compared to the national average and his rate of infections as compared to the national average.
Results: At the 6-month follow-up, 82% of patients experienced significant pain relief (defined as ≥50% reduction in pain), while 72% demonstrated improved function, and 42% showed a reduction in medication usage.
The national average for lead migration in similar cases ranges between 2-9%. However, in the cohort of 101 patients followed by Dr. Gupta, no instances of lead migration were observed.
Dr Gupta has also looked at healthcare utilization how the patients who were offered Neuromodulation therapy for intractable back and leg. Pain can help patients improve the quality of life and minimize their opioid consumption.
Results: The analysis included 47 patients with a mean follow-up of 15.6 ± 6.2 months. Average pain relief was 73 ± 22%, with 89% being responders. Annual medical interventions dropped from 3.48±3.05 to 0.49±1.16 (P < 0.001). Among 30 patients, 89% reduced or maintained opioid use after implantation.
Device photos displaying stimulators and leads.
