Spinal Cord Stimulation

What is a spinal cord stimulator (SCS) / a peripheral nerve stimulator (PCS)?

• Spinal cord stimulation has become an increasingly popular treatment option for patients who suffer from chronic neck or back pain.
• This stimulator has similarities to a cardiac pacemaker, leading some to call the device a “pacemaker for pain” that works by blocking pain signals from the spinal cord travelling through to the brain.
• Besides the SCS, the peripheral nerve stimulator is used to target nerves outside the spine, for example, in the shoulder or the knee, in order to help relieve the chronic pain in the limbs.

What is a stimulation trial?

Before being implanted with a SCS, you are advisable to undergo a stimulation trial procedure to see if you will benefit from the procedure. This takes about 45 minutes.

• Surgical insertion of stimulating leads next to the spinal cord or a peripheral nerve 
• A day surgery under ultrasound or fluoroscopic guidance, following which you can be discharged home 
• The evaluating period is for about 7 to 10 days 
• We will arrange another appointment for the permanent implant to be placed should the trial be successful 

During the evaluation period, should you experience a reduction in pain and your reliance on pain medications, it means the trial has shown good results. You should be able to resume normal activities like traveling, sport activities and work. 

How is the permanent spinal cord stimulator implanted?

An implantation of a stimulator: 

• Will take around 2 hours 
• Will be performed under general anaesthesia or deep sedation 
• Involves placement of the leads and cables under the skin, whereas the pulse generator will be implanted in the flank 
• The stimulator will then be able to produce continuous pain relief 
• A remote control will be provided for setting adjustments 
• Close follow-ups are necessary initially to achieve the optimal setting for pain relief 

What are the possible risks?

Generally, SCS or PCS is a safe and effective procedure, which is also completely reversible. The risks are often minor, but may include: 

• Soreness and bruising over the injection point 
• Potential infection 
• Spinal cord nerve damage 
• Allergic reaction
• Device malfunction 
• Weakness, numbness

What should I expect after the procedure?

• An increase in back pain for 48 to 72 hours
• You must not bend, stretch, twist or lift with big movements or more than 45 degrees 
• Check your back for redness, swelling or any discharge regularly 
• Keep the insertion area of stimulator and the dressing dry and clean all the time 
• Wipe yourself with a damp cloth instead of taking a shower 
• The clinic will call and check on you daily 
• A follow-up date in a week

Every condition is different, hence it is best to consult a specialist who is experienced in managing such conditions. Reach out to Dr Timothy Thor today.