Spinal Cord Stimulation
Spinal cord stimulation (SCS) delivers low-voltage electrical impulses to the dorsal columns of the spinal cord, masking pain signals before they reach the brain. Modern SCS systems include traditional tonic stimulation, high-frequency (10 kHz) stimulation, and burst stimulation patterns.
What Is It & Who May Benefit?
Spinal cord stimulation (SCS) delivers low-voltage electrical impulses to the dorsal columns of the spinal cord, masking pain signals before they reach the brain. Modern SCS systems include traditional tonic stimulation, high-frequency (10 kHz) stimulation, and burst stimulation patterns.
Symptoms
- Failed back surgery syndrome (FBSS)
- Complex regional pain syndrome (CRPS)
- Chronic intractable neuropathic pain
- Peripheral ischemic pain
- Chronic angina
- Chronic pelvic pain
How It's Performed
Trial period first (5-7 days with externalized leads)
Patient positioned prone under fluoroscopy
Percutaneous epidural needle placement at target level
Electrode leads advanced to target position on dorsal columns
Test stimulation to confirm coverage of painful area
If trial successful (>50% pain relief), permanent implant performed
Generator implanted subcutaneously in the buttock or abdominal wall
Programming optimization over several weeks
Risks & Complications
- Lead migration (5-10%)
- Hardware malfunction
- Infection (3-5%)
- Epidural hematoma
- Dural puncture
- Inadequate pain coverage
- Need for revision surgery
- Loss of efficacy over time
Benefits
- Significant pain relief in well-selected patients (50-70% achieve >50% relief)
- Reversible and adjustable
- Reduced opioid consumption
- Improved function and quality of life
- No permanent nerve destruction
- Advanced waveforms provide more natural paresthesia-free stimulation
Recovery
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Is This Procedure Right for You?
A thorough clinical evaluation is essential to determine whether spinal cord stimulation is appropriate for your specific condition.
Dr. Shahnawaz F Shah