Spinal Cord Stimulation
What is Spinal Cord Stimulation
Spinal Cord Stimulation (SCS) also known as Dorsal Column Stimulation (DCS) is an advanced treatment for low back, neck, arm, and leg pain that has not responded to more conservative interventions. This may include physical therapy, certain types of medications, and injections. Spinal Cord Stimulation involves placing tiny electrical leads in to the back and delivering energy to the spinal cord to help mask the pain signals from getting to the brain.
Who is a potential candidate for Spinal Cord Stimulation?
Spinal cord stimulation can be used to treat a wide variety of pain conditions but has been best proven to treat patients with persistent back, neck, arm, or leg pain after surgery and are not candidates for further surgery to try and correct the problem. Once all conservative treatments have failed, SCS can be an excellent option for treating pain. Other patients who may benefit from SCS are those who have been diagnosed with complex regional pain syndrome (CRPS) formerly known as reflex sympathetic dystrophy (RSD).
What do I do if I think I am a candidate for Spinal Cord Stimulation?
If you think you may be a candidate for spinal cord stimulation we would encourage you to schedule a consultation with Dr. Trainor to discuss this treatment in more detail. During the consultation Dr. Trainor will review your history, imaging, and perform a physical examination. If he determines that you are a good candidate for SCS he will go over the details and process for moving forward.
What is the process of moving forward with Spinal Cord Stimulation?
If the decision is made to move forward with spinal cord stimulation, you will need updated MRIs (within the last year). If these have not been performed they will be ordered during your consultation. You will also be scheduled to meet with a pain psychologist to discuss any psychological barriers to moving forward with SCS (this is a requirement by insurance companies). Once your imaging is complete, you have met with a pain psychologist, and pre-authorization has been obtained from your insurance company, you will be scheduled for a SCS trial. During the trial, small temporary electrical leads will be placed through the skin into the back part of the spinal cord (dorsal epidural space). Once the leads are in the correct place, the leads are taped down to your back and plugged into an external battery. You will go about your daily life for approximately one week with the temporary leads in place. If you have at least 50% reduction in your pain during that week you are a candidate for permanent implantation which takes place 4-weeks after the end of the trial. Permanent implantation involves creating a small incision in the middle of your back where the leads will go into the epidural space. These leads will be secured to the muscle and the incision will be closed. You will have a second incision, most often in the flank region where the battery will be placed under the skin. After the operation you will see Dr. Trainor 10-14 days after the procedure, so he can check your incision. You will then follow up 6-weeks after the operation at which time you will be allowed to increase your physical activity.