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Spinal Cord Stimulation

Procedure Benefits:

  • Effective in 50-70% of cases
  • Pain signals are inhibited without use of opiates or other controlled substances
  • Non-invasive “trial“ period before implantation increases chances of effectiveness
  • 100% reversible through ex-plant
  • No hospital stay- procedure is performed in an out-patient surgical setting
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Overview

Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

About the Procedure

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Trial Implantation
The injection site is anesthetized. One or more insulated wire leads are inserted through an epidural needle or through a small incision into the space surrounding the spinal cord, called the epidural space.

Find the Right Location
Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. The patient gives feedback to help the physician determine where to place the stimulators to best block the patient’s pain. The leads are connected to an external trial stimulator, which will be used for approximately one week to determine if SCS will help the patient.

Determine Effectiveness
If the patient and the physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the leads are removed.
Permanent Implantation
The permanent implantation may be performed while the patient is under sedation or general anesthesia. First, one or more permanent leads are inserted through an epidural needle or a small incision into the predetermined location in the epidural space.

Generator Implantation

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Next, a small incision is created, and the implantable pulse generator (IPG) battery is positioned beneath the skin. It is most often implanted in the buttocks or the abdomen. The leads are then connected to the IPG battery.

End of Procedure
The implant’s electrical pulses are programmed with an external wireless programmer. The patient can use the programmer to turn the system on or off, adjust the stimulation power level and switch between different programs.

After the Procedure

You will have a small incision that you should keep clean and dry until it heals. If the procedure is successful, you may feel that your pain may be gone or quite less. You will experience a fairly constant sensation of stimulation. You may have soreness due to the needles used for a day or two.

As with any procedure, there are potential risks. Although discography is designed to minimize these risks as much as possible, there is a chance that complications could occur. Be sure to discuss the possible risks with your doctor. Also, please note that not all patients are candidates for discography. For more information on specific risks, please speak with your physician.

Frequently Asked Questions


Am I a candidate for Spinal Cord Stimulator?
Garden State Medical Center offers in-office Spinal Cord Stimulator trials to patients with chronic and severe pain, who have not responded to other treatment modalities. Most of these patients are suffering from back and/or leg pain after back surgeries, chronic radiculopathy, neuropathic pain, or RSD (Reflex Sympathetic Dystrophy) or CRPS (Complex Regional Pain Syndrome). To find out if you may benefit from this procedure, please give us a call.
Will the Spinal Cord Stimulator help me?
It is very difficult to predict if the procedure will indeed help you or not. For that reason temporary wires are placed to determine if this device will be effective to relieve your pain or not. Typically, patients will have a 50 to 70 % reduction in their pain.
What are the alternatives?
Conservative treatment (e.g. physical therapy, exercise regimens and nonsteroidal anti-inflammatory medications) is often used first. Surgery is a possible alternative, however, these procedures may be an adequate treatment, providing temporary relief. These procedures can help determine if surgery would be of benefit by more precisely localizing the source of your symptoms. In most cases, many of these options will be exhausted prior to considering SCS.