What is a Spinal Cord Stimulation?
For more than 40 years, Spinal Cord Stimulation (SCS), where electrical pulses are delivered to targeted areas of the spinal cord, has been used to successfully manage pain in a wide variety of conditions. SCS is usually indicated for Nerve pain syndromes in which nerves outside the brain and spinal cord continuously cause pain impulses to the brain, leading to constant severe pain. The system can be thought of as an Internal Pacemaker for Pain.
While the exact physiologic mechanism underlying SCS is unknown, use of the SCS is based on the theory that non-painful, electrical impulses transmitted over the spinal cord can interfere and block the continuous nearby traveling pain signals causing your chronic pain. This is known in medicine as the Gate ‘Control’ Theory of pain.
SCS is generally reserved as a last resort for patients who’ve been unsuccessful with alternative, and more conventional, approaches to pain management, including medications, physical therapy and nerve blocks.
What is the Typical Procedure?
The Spinal Cord Stimulation (SCS) procedure is performed in 2 stages. First is the SCS Trial which is performed by your physician at The Gulf Coast Pain Institute. This is completed just like any other Injection you have had before. It is an out-patient procedure which requires the same rules as you have followed for all other procedures with the exception that if you are on any blood thinners these MUST not be taken 5-7 days prior to the trial AND cannot be restarted until AFTER the SCS trial is completed. The SCS trial is performed by placing a very small electrode through a
specialized needle above the area where your pain is, then the electrode is turned on and a variety of stimulation patterns are checked to see which one is best at covering all the areas where you have pain. Once the perfect positions of the Electrodes are identified they are secured in place, a large bandage is used to keep the electrodes sterile.
In the recovery room our SCS specialists optimizes the stimulation coverage based on your pain pattern. You are discharged home to use the stimulator for approximately 7 days and identify whether it relieves all or most of your pain. During this trial period the SCS specialists will be communicating with you daily to ensure that the programing is as good as possible based on your pain pattern. After the 7 days you are reevaluated and the temporary trial electrodes are removed. This is completely painless and based on your overall pain relief from the trial it is determined whether you are a candidate to have the permanent SCS implanted by one of our Spine Surgeons. This is so that the permanent electrodes can be surgically positioned and the pacemaker battery can be implanted into position. This pacemaker battery is rechargeable and can be reprogramed to optimize your pain coverage just like a TV remote changes your TV channels.
What should I expect following the procedure?
Initially you may have some increase in discomfort due to the initial irritation from the procedure. The pain relief can however actually begin immediately after the procedure. We ask that over the first 48 hours you just try to relax and enjoy the pain relief. If the stimulation is not covering all of your painful areas you will have been given several programs to work with. As the SCS specialists will have given you there phone numbers contact them if you have any questions or concerns. If you are not getting perfect stimulation the SCS may need to be reprogramed by our specialist, please let them know. Please try to keep your bandages dry and reinforce with the extra tape provided to ensure that it remains sterile. You will be given an antibiotic to take throughout the trial period. Certainly if you have any additional concerns prior to or following the procedure please call our office at 850-484-4080, our doctor on call or call the surgical center where the procedure was performed.