FAQs on Spinal Cord Stimulator Implant in Atlanta

A spinal cord stimulator (SCS) is a specialized device used to stimulate the spinal cord and associated nerves. Tiny electrical impulses are transmitted via a small wire placed behind and outside the spinal cord. This wire contains several electrodes that can be programmed to generate tiny electrical currents.

Am I a candidate for a spinal cord stimulator?

SCSs are recommended for patients with severe, chronic neuropathic pain, who have not had good results with conservative treatment measures. Neuropathic pain occurs from damaged nerve tissues, as in reflex sympathetic dystrophy, complex regional pain syndrome, post-laminectomy nerve damage, diabetic neuropathy, and radiculopathy.

What is a spinal cord stimulator trial, and how does this differ from permanent implantation?

A SCS generates a low-level electric field, which interrupts nerve conduction of pain signals. A patient is usually first given a trial of the spinal cord stimulation, which involves the placement of a temporary SCS wire. This gives the person a chance to experience spinal cord stimulation without having to undergo surgical implantation. If the trial works, the permanent device is implanted under the skin at another time.

How is the SCS implant performed?

Placement of the permanent SCS wire with a pulse generator takes about an hour. The patient’s vital signs, heart rhythm, and oxygen level are monitored during the procedure, which is performed under strict sterile conditions. The pain management doctor numbs the skin and deeper tissues with a local anesthetic, and small incisions are made over the area that is problematic.

An introducer needle is passed into the epidural space near the spinal cord. The electrodes are inserted through the introducer needle and adjusted. Once positioned, the needle is removed, and a bandage is applied. For pain of the lower back and legs, the electrodes are inserted in the lower back, and the generator is placed on the side of the buttock or lower abdomen.

Does the spinal cord stimulator implant procedure hurt?

The procedure involves use of a needle to introduce the electrodes, so there is some pain involved. However, you will be given IV sedation that makes the procedure easy to tolerate, and a local anesthetic is used to numb the skin and deeper tissues.

What should I expect after the SCS implantation procedure?

When the procedure is successful, pain is lessened or eliminated. You will usually feel a constant sensation of stimulation, which is described as tingling and warmth. Patients often report soreness for 1-2 days due to the incisions and needle insertion.

You will need to bring someone with you to drive you home, as you are not permitted to drive for 1-2 days. In addition, patients are advised to avoid lifting, bending, and twisting of the spine for a couple of days.

How long will the generator last?

The batteries may be internal or external, depending on the device used. The generator lasts several years with internal batteries, but these batteries must be surgically replaced. With external batteries, they are easily replaced when needed.

What precautions are to be considered?

You are not permitted to have a magnetic resonance imaging (MRI) scan with an SCS. In addition, you should not have any deep heating or electrical physical therapy treatments (diathermy). The MRI or diathermy could raise the electrical wire or electrode temperature and harm the spinal cord or spinal nerves. Many patients pass through security checkpoints with ease, but you should provide identification indicating a medical device to make sure you have no difficulties.

Does the spinal cord stimulator work?

Spinal cord stimulation is not effective for all patients, which is why the temporary electrode trial is performed. Usually, patients report a 50-70% reduction in pain with SCS.

Many clinical studies show effectiveness of SCS for pain reduction and improvement of functional status. In one study of 70 patients who had SCS for 1 year, patients reported significant long-term improvement of pain scores.

In a study looking at spinal cord stimulator implants for neuropathy, over 3/4 of patients experienced pain relief along with improvement of sensation. It’s often a remarkable life changer for  those dealing with chronic pain where surgery is not indicated.