What to Expect with Procedures

Spinal Cord Stimulation

Spinal Cord Stimulation (SCS) uses low voltage stimulation of the spinal nerves to block the feeling of pain. It helps you to better manage your pain and potentially decrease the amount of pain medication you require. A small wire carries the current from a pulse generator to the nerve fibers of the spinal cord; this results in a tingling sensation instead of pain. By interrupting pain signals, the procedure has shown success in improving some patient’s quality of life.

Will the SCS cure my pain?

No, the procedure will help to lessen your pain and improve your quality of life. The SCS does not eliminate the source of the pain; it simply interrupts the pain signal to the brain. How much relief and for how long varies among patients (depending on other medical conditions), the source of your pain and how long you been having this problem. For this reason, a trial is performed before the device is permanently implanted.

Are there any side effects or complications?

Yes, the SCS procedure is very safe, but as with any other medical procedure, it has risks. The most common complication is a headache. This happens in 1 in every 100-200 cases. Other more serious complications, such as lead migration, infection, allergic reaction, nerve damage, bleeding and paralysis are extremely rare. Infection is a relatively common complication. For this reason, we recommend all patients to bathe or shower the day of the procedure to minimize this risk.

Am I a candidate?

Before deciding if you are a good candidate your condition will be carefully evaluated by our staff. Our doctors will review the nature of your pain and all your current and previous treatments before deciding if your condition could be helped with this technology. Since chronic pain has an important physiological component, you will require a psychological evaluation to determine if you are a good candidate.

Most of the patients selected for this procedure have chronic back and leg pain that persist after 1-2 surgeries. Other common conditions include chronic neck and arm pain, complex regional pain syndrome, peripheral vascular disease, neuropathies, etc.

How is SCS done?

First we will do a trial, which will consist of the placement of a percutaneous lead (which usually has 4 to 8 electrodes on it). This will be connected to an external device that will have 2-4 different programs to cover your pain. You will then go home and try the device for the next 5-7 days, after which you will be seen in our clinic to decide if the device had relieved your pain and improved your functionality. We usually consider it a successful trial if your pain was relieved by at least 50-70%.

This procedure usually requires 30-60 minutes to perform.

If you have a successful trial, we will then proceed with the permanent placement of the lead and a pulse generator (battery); this will require a small surgical procedure usually done as an outpatient, although you might be required to stay 24-48 hours, depending on the type of procedure and other medical problems you might have.

There are two different ways to do the permanent placement. Depending on your functionality, health status and other parameters, our staff will decide which of the two will be better for you.

The time required to do the procedure varies from patient to patient, but it usually lasts 45-90 minutes.

Are there any activity restrictions?

We prefer you minimize certain activities that will require excessive bending or rotation of your lower back, since the lead can easily migrate in the first 4-6 weeks after the permanent placement. We also ask you not to shower (only sponge bath) after you are seen in the clinic for your first post-op visit (usually 7-10 days after the procedure).

Is it safe?

Yes, but as previously mentioned, complications might occur, as well as side effects from the steroids. The most common complication is a headache. This can occur a few hours after the procedure, or up to two days after. If this happens you should contact our office immediately. Another common complication is infection; we recommend that you shower or bathe the morning of the procedure to minimize risk.

Other more serious, but very rare complications can occur, such as nerve damage, meningitis, bleeding or paralysis. Our staff will discuss in detail the risk and benefits before scheduling for this injection.

I have had a SCS trial before and it did not help. Should I do another one?

It will vary from patient to patient, and how long ago the trial was performed. In the last few years, there have been significant advances in the technology, allowing us to treat patients that failed previous trials.

What if the procedure does not alleviate my pain?

There are other therapies that we can use to manage your pain. Using different methods to treat your pain is the most successful way to relieve your pain and improve your quality of life. Other strategies to treat your pain include exercise, relaxation, and changing negative thought patterns can help you cope better with pain.

Who should not have the injection?

  • If you are pregnant or breastfeeding.
  • If you have a severe allergic reaction to local anesthetics.
  • If you are taking a blood thinner, such as Warfarin (Coumadin), Enoxaparin (Lovenox), Clopidogrel (Plavix), etc; and your medical condition does not allow us to stop it a few days prior to the procedure.
  • If you develop fever or any infection.

Contact our office if you experience:

  • A severe headache
  • A fever
  • Pain that is more severe than prior to the injection
  • Increased back pain or back stiffness

Go to the nearest Emergency Department or call 911 if you develop any new numbness, weakness, and/or paralysis in your arms or legs or lose control of your bladder or bowels.

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