A Spinal Cord Stimulator (SCS) is an advanced, implantable device used to manage chronic neuropathic pain that does not respond to medications, injections, or surgery. The stimulator delivers mild electrical impulses to the spinal cord, modulating pain signals before they reach the brain. This technique does not “numb” the body — instead, it changes how pain is perceived, often replacing it with a gentle tingling or complete relief. SCS offers life-changing benefits for carefully selected patients, helping them regain mobility, reduce medication use, and restore daily function.
Indications
Spinal cord stimulation is primarily used for patients suffering from:
- Failed Back Surgery Syndrome (FBSS) — persistent pain after spinal surgery
- Chronic radicular pain (sciatica, cervical or lumbar nerve pain)
- Complex Regional Pain Syndrome (CRPS)
- Post-traumatic or post-herpetic neuropathic pain
- Peripheral vascular disease–related pain (in select cases)
- Diabetic neuropathy (resistant to medication)
SCS is most effective when pain is neuropathic (nerve-related) and the structural cause has been surgically corrected or stabilized.
Mechanism
The stimulator consists of:
- Electrodes (leads): thin flexible wires placed in the epidural space near the spinal cord.
- Implantable pulse generator (IPG): a small battery-powered device placed under the skin, typically in the buttock or abdominal area.
- External programmer: allows the patient and physician to adjust stimulation settings wirelessly.
Electrical pulses from the IPG interfere with pain transmission in the dorsal columns of the spinal cord, replacing pain sensations with a comfortable tingling or completely neutral feeling.
Procedure
1. Trial Phase
- Performed under local anesthesia in an outpatient setting.
- Electrodes are inserted into the epidural space using fluoroscopic (X-ray) guidance.
- The leads are connected to an external stimulator worn on a belt for 5–7 days.
- If the patient reports ≥50% pain reduction and functional improvement, the permanent system is implanted.
2. Permanent Implantation
- Conducted under local or general anesthesia.
- Trial leads are replaced with permanent ones and connected to the implantable pulse generator (IPG) under the skin.
- The procedure typically lasts 60–90 minutes, and patients usually go home the same day or after an overnight stay.
- Stimulation settings are individually programmed to optimize comfort and pain control.
Expected Benefits
- Significant pain reduction (often >50%)
- Decreased need for pain medications
- Improved mobility and quality of life
- Better sleep and psychological well-being
- Reversible and adjustable — the device can be turned off or reprogrammed anytime
SCS does not cure the underlying disease but provides durable pain relief and functional improvement in suitable candidates.
Risks & Complications
- Lead migration or displacement, causing reduced effectiveness
- Infection at the implant site
- Battery or hardware malfunction (rare, replaceable)
- Temporary numbness or tingling changes
- Pain at the implant site (usually mild and temporary)
All components are MRI-compatible in modern systems, and periodic battery replacement (every 7–10 years) may be required.
Recovery & Follow-Up
- Most patients resume daily activities within a few days.
- Wound healing occurs within 2–3 weeks.
- Patients are taught how to use the remote control to adjust stimulation intensity.
- Follow-up visits are scheduled for program optimization and system checks.
- Regular review ensures stable long-term function and battery performance.
When used as part of a multidisciplinary pain management plan, SCS can significantly reduce medication dependence and restore independence.
Patient Advisory
Spinal cord stimulation is not suitable for all chronic pain conditions. Each patient must undergo careful evaluation and trial testing before permanent implantation. Success depends on accurate diagnosis, psychological readiness, and adherence to rehabilitation. Consult your treating neurosurgeon or pain specialist to determine if SCS is the right solution for you. Do not base medical decisions solely on online information.