Spinal Cord Stimulators are electronic devices which are implanted under the skin (in the lower back area mostly) of patients who are suffering from chronic back pains. First used to treat pain as early as 1967, the Spinal Cord Stimulator emits low levels of electrical pulse along the spinal column of human body, modifying the nerve activity to control the sensation of chronic back pains.
This process was approved by the FDA in 1989 to relieve pain from serious nerve damage in the lower portion of the body and now is used in more than 70% of all neuromodulation treatments. Recent advancements in the battery and microprocessor power have allowed these devices to have a longer lifespan and higher precision, which requires lower maintenance. There are rechargeable Spinal Cord Stimulators in the market now, which removes the need for further surgeries for patients if the battery in the stimulator dies out in a few years after the implant.
Benefits of SCS-: Reduces the chronic back pain considerably (about 50-70%)- Can also be deployed in cases of Ischemic pain due to peripheral vascular diseases, post amputation pain and in cases of Regional pain syndrome- Applicable in cases of Abdominal or organ pain from a number of chronic conditions like pancreatitis.
The initial cost of SCS is recovered in 2-3 years as the patients have to incur fewer costs in medical visits, reduced painkiller usage and patients who opt for SCS are able to return to work far quicker
Programming for SCS involves choosing the electrode stimulating configuration, adjusting the amplitude levels, and the width and frequency of electrical pulses. The amplitude levels indicate the intensity of stimulation which is delivered in mA or Volts; a lower voltage or current is used for peripheral nerves and paddle leads. The pulse width is adjusted to broaden or shorten the area of paraesthesia. Similarly, the patient is allowed to choose the frequency of the pulse wave – some choose the low frequency beating sensation while others go for a high frequency buzz.
Chronic Pain Management using SCS
Chronic back pains characteristically last for a period of at least six months or more and so more often than not they are not cured by the first line of treatment (like pain relief medication, chiropractic treatments, physical therapy etc.). Thereafter, depending upon the patient’s condition a pain management plan is chalked out by the experts, which may include one or a combination of pain treatment procedures, physical therapy and nerve blocks. If these therapies or combination of therapies are still unable to relieve the pain, more advanced mechanisms such as Spinal Cord Stimulation is deployed. SCS are mainly used to cure following two types of chronic pains :
i) Neuropathic Pain (involves severe nerve damage)
ii) Chronic back pain from a failed back surgery syndrome
iii) Sciatica cases
Potential Risks and Side-Effects of using SCS
While the risks are comparatively low for patients undergoing SCS implantation surgery than what it is for patients who choose more invasive surgical methods, a few risk factors must be considered before opting for this procedure. Some side effects may include:
– Bleeding- Allergic Reactions
– Numbness- Paralysis
– Consistent pain around the operated area
– Battery failure or leakage
– Post surgical soreness