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Spinal Cord Stimulators

Spinal Cord Stimulators

A spinal cord stimulator is a device used to exert pulsed electrical signals to the spinal cord to control chronic pain. In the simplest form, spinal cord stimulation (SCS), consists of stimulating electrodes implanted in the epidural space, an electrical pulse generator implanted in the lower abdominal area or gluteal region, conducting wires connecting the electrodes to the generator, and the generator remote control. SCS has notable analgesic properties and at present is used mostly in the treatment of failed back surgery syndrome, complex regional pain syndrome and refractory pain due to ischemia.

SCS is analgesia on demand. It is a useful option when other forms of therapy fail. It reduces pain medication and side effects. It is effective in about 50–70% cases. It is an invasive procedure, so it can have associated complications such as infection, bleeding, and dural puncture. It has the risk of disconnection or equipment failure.

SCS interaction with diathermy, pacemakers, MRI and therapeutic ultrasound can result in unexpected changes in stimulation, serious patient injury or death. It can also lead to failure of the device.

Appropriate patients for neurostimulation implants must meet the following criteria: the patient has a diagnosis amenable to this therapy, the patient has failed conservative therapy, significant psychological issues have been ruled out, and a trial has demonstrated pain relief. A trial period of stimulation over a period of 5–7 days should follow the psychiatric evaluation to demonstrate its effectiveness. This part of the protocol is important because of the cost of the equipment and the invasive nature of the procedure. The trial is considered successful if the patient achieves more than a 50% reduction in pain.

SCS electrode device

spinal cord stimulator chronic pain relief