What is Spinal Cord Stimulation?
Spinal Cord Stimulation (SCS) decreases your perception or feeling of pain by blocking some types of pain signals from being processed by your brain. The actual way that it works is quite complicated and involves action at both your brain and spinal cord levels. SCS will not block ALL types of pain. In addition, SCS does not “cure” the source of your pain or fix damaged nerves that give muscular weakness Pain such as arthritic pain and most “acute” pain will not be blocked by these devices.
SCS is typically only used when all other methods of pain control have failed or are not tolerated. A “trial” or test of the device is always done before deciding to move on to a permanent device. In a trial, your physician will see if they can place a needle into the epidural space at a level they can thread the lead/electrode(s) to an area of the spinal cord that we need to stimulate. Secondly, your physician will see if he/she can “cover” or place a gentle buzzing or tingling sensation in the areas where you feel pain. Generally, if we can’t stimulate the area that you feel you pain in, we can’t block it. Lastly, we “trial” the device by letting you go home and see how much pain relief, if any, you may obtain. There are obviously NO GUARANTEES that this procedure, or any other type of treatment, will relieve your pain.
What can you expect during the procedure?
A “Trial” procedure is typically done in the Pain Center while a permanent implant is always done in the operating room. For either procedure you will require an Intravenous needle placed in your vein. This will allow for a pre-procedure dose of antibiotic medicine as well as allow you to be given medicine to help you relax and decrease any pain you may experience during the procedure. You can’t be totally “asleep” for this procedure. Your vital signs will be watched with several monitors for your safety. Fluoroscopy (X-Ray) will be used to guide the lead/electrode(s) to the correct position. After the lead/electrode(s) are where we believe that they should be, the Spinal Stimulator Company representative will begin programming of the stimulator in an effort to try and “cover” your painful area with stimulation. We may need to reposition the lead/electrode(s) in order to appropriately “capture” the area where your pain is. Sometimes, this is not possible, however, due to a variety of conditions and circumstances. In that case, the procedure may be stopped. The procedure is performed under aseptic (sterile) conditions.
What can you expect after the procedure?
If this is a “trial” stimulator placement, you will be discharged home after the procedure. If this is a “permanent” stimulator implant, you will remain in the hospital overnight. If sedated during your procedure, you will need someone to drive you home, as you may be drowsy from the medications. Further, you are restricted from driving any automobile or motorized/mechanized vehicle that day or from operating heavy machinery/equipment of any type that day. Even if you have not had sedation, you should not lift anything heavier than 5 pounds or do any type of strenuous work that day. It is possible for you to have some increased pain after a trial procedure due to the placement of the needle(s) and lead/electrodes. It is probable that you will have pain from the incisions needed to implant a permanent spinal stimulator. Do not get the dressing around the stimulator wet. You may shower after the trial lead/electrode(s) is/are removed and about one week after implant of the permanent system if your incisions appear to be healing well.
If an implanted battery/generator has been used, this battery will eventually require changing. The battery life will vary, depending on whether it is a rechargeable or non-rechargeable battery and the settings and hours per day you use your stimulator. Replacement of the battery/generator is a minor surgical procedure usually done as an outpatient.
Further instructions will be given by your physician after your procedure.