Spinal Cord Stimulation (SCS)

What is Spinal Cord Stimulation?

Spinal Cord Stimulation (SCS) is a minimally invasive, outpatient procedure designed to treat chronic, severe nerve pain in the neck and arms or low back and legs that has not adequately responded to conservative care and no further corrective surgery is indicated. SCS was initially developed in the 1960s and has undergone major advancements in the technology, efficacy, and safety over many years. 

How Does It Work?

• Under local anesthesia plus a sedative medication, 1 or 2 needles are placed into the epidural space using x-ray guidance, similar to how an epidural steroid injection would be administered. 
• Next, very thin, catheter-like leads that contain electrodes are inserted through the needles and into the epidural space using live video x-ray. This is similar to how an epidural catheter for pain relief during labor or abdominal surgery would be placed, though x-ray guidance allows for more precise SCS placement.
• Next, the needles are removed, while the leads remain partially under the skin and are connected to an external, wireless remote control that can adjust the device’s ability to block chronic pain signals from reaching the brain, similar to the way that noise-cancelling headphones eliminate certain sounds.
• Patients are discharged home the same day and go about the majority of their typical activities, with only minor restrictions, to “trial” the device for several days to a week. This allows patients to determine if SCS provides adequate pain control and functional improvement to warrant permanent implantation.
• The trial leads with electrodes are then removed in your doctor’s office after a few days to a week. 
• If the SCS trial is successful, a permanent SCS system can be implanted.  The generator and battery unit (internal pulse generator, IPG) is approximately the size of an Oreo cookie and is implanted under the skin of the lower back or upper gluteal region and connected to the leads that are under the skin.  The IPG is typically replaced every 8 to 10 years.

Why is Spinal Cord Stimulation Performed?

SCS is typically recommended for patients with:

• Spinal pain with severe nerve pain in the arms or legs
• Inadequate pain relief with more conservative treatment options and no further corrective spinal surgery is advised.
• Most common diagnoses are failed back surgical syndrome and complex regional pain syndrome

Benefits of SCS

• Trial Phase: Patients are able to get a sense of how SCS will affect their pain during a trial prior to having any incisions or devices permanently implanted.
• Minimally Invasive: the SCS trial is fully completed through needles (no incisions) and the permanent implant only requires a small incision.
• Quick Recovery: Patients return to their normal activities within a few days after the SCS trial and weeks after the permanent implant procedure.

Risks and Considerations

SCS is considered a very safe procedure; however, like all medical procedures, it does carry some extremely rare risks for which multiple safeguards exist against. Your doctor will discuss these potential risks with you and determine if SCS is the right treatment option for your condition.

Is Spinal Cord Stimulation Right for Me?

SCS is not suitable for everyone. If you’re experiencing spinal pain with severe nerve pain in the arms or legs, for which no further corrective spinal surgery is recommended, consult with one of our specialists to find a solution.