Spinal Cord Stimulation
A Spinal Cord Stimulator(SCS) or Dorsal Column Stimulator (DCS) is an implantable medical device used to treat chronic pain of neurologic origin. An electric impulse generated by the device near the dorsal surface of the spinal cord provides a paresthesia (”tingling”) sensation that alters the perception of pain by the patient.
A trial is usually done before the permanent unit is placed. A temporary percutaneous lead is used and is connected to an external pulse generator. The trial is from 3 to 7 days. If the patient has at least 50% improvement in pain during the trial, the patient is considered a candidate for the permanent unit.
A surgeon introduces the spinal cord stimulator lead into the epidural space in the spinal canal either by using a needle in a percutaneous approach or by a surgical laminectomy or laminotomy. A pulse generator or RF receiver is implanted in the abdomen or buttocks. A wire harness connects the lead to the pulse generator.
The patient is provided a remote control to turn on and off the stimulator, and depending on the device and the surgeon’s preference, allows for limited programming of the stimulation patterns. The surgeon has a programming device that provides a wide range of stimulation settings.
Patients with SCS units are not able to have MRI procedures, must avoid areas with high electrical fields, and take caution with anti-theft and metal detector gates. Patients are provided an ID card to allow them to bypass airport security screening gates. Certain other medical procedures must be avoided.
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