Spinal Cord Stimulator (SCS) Implant
A spinal cord stimulator is one of two types of implantable devices designed to block the transmission of pain to the brain, from the spinal cord or peripheral nervous system. Implantable devices may be used in cases of chronic back pain where a patient has moderate to severe pain levels that continue despite the application of several types of back pain treatments. These devices are in severe back cases where other treatments have failed, the pain is severe. The two main types of implantable devices to block the transmission of pain up the spinal cord include those that deliver electrical stimulation to the nerves, and those that deliver narcotic pain medications. These types of treatments may be used when the prognosis is poor towards treating/curing the cause of the back pain, but yet when the patient cannot continue to function at their present pain levels. The implantation of these devices, though a serious decision to make for the patient, may offer more benefits to the patient, with fewer side effects, as opposed to other types of treatments such as NSAIDS, orally taken narcotic pain meds, and steroids. These types of medications all have the ability to cause major problems with the gastrointestinal (GI) tract, dependence and addiction, and the destruction of bone and soft tissue - as is the case with orally taken and injected steroids.
Spinal Cord Stimulator (SCS) Implant: Neuropathic pain involves the transmission of pain from nerves in the peripheral nervous system, to the spinal cord, up the spinal cord, and to the pain centers of the brain. We may experience severe pain when the frequency and strength of these signals accumulates in the brain to the point where we experience significant pain. With this technology, an electrode is placed in the epidural space of the spinal cord. On one end of this electrode in an internal battery (generator) implanted in the body, which is capable to delivering a low level electrical pulse. The other end of the electrode inserts directly into the epidural space of the spinal cord. The epidural space of the spinal cord is the outermost section of the spinal canal, with the Dura mater layer o towards the outside and the arachnoid mater on the inside. This delivery of an electrical pulse, at regular times intervals, blocks the transmission of pain from traveling beyond this point.
There are three steps to the implantation and installation of this device:
- The surgical implantation of the battery and the insertion of the electrode into the epidural space.
- Repeat visits to the doctor at regularly timed visits to recharge the battery.
- The frequency of the delivery of the electrical charges delivered and the amount of energy in them may be changed by remote control of the doctor upon follow-up visits to evaluate and monitor the patient's progress with the device.
Procedure: The unit itself consists of a generator, conducting wires, and implanted stimulating electrodes. The power source for the generator is typically located within the generator, within the body. The generator unit is usually implanted in the posterior gluteal region or the lower abdominal area.
Usually, the first phase of this treatment includes the implantation of the conducting wires and stimulating electrodes - into the epidural space. The conducting wires and electrodes are stimulated by a remote control on the outside of the patient's body that they can manipulate. The first phase is a trial period of about 5-7 days, and patients will see their doctors again at the end of the trial period to report whether of not they experienced significant pain relief.
If at the end of the trial period results in significant improvement for the patient, the electrodes will be permanently anchored to the interspinal ligaments. the patient may then continue to stimulate the wires via an external power source, or a permanent generator may be implanted in the body.