Spinal Cord Stimulation
For nerve-related chronic pain, neuromodulation can be used to help improve your symptoms. Neuromodulation involves altering the pain signals that travel along your nerves and spinal cord. Spinal cord stimulation (SCS) is a neuromodulation treatment option that offers a unique form of pain management through an implanted electrical stimulator called a pulse generator.
Using electrodes to control neurostimulation (or stimulation in the nerves), SCS targets nerve pathways along your spinal cord that are sources of chronic pain, numbness, and paresthesia (tingling). Through SCS, you can control the stimulator's levels to significantly reduce chronic pain and other side effects of certain nerve and spinal problems.
A skilled pain specialist will be able to perform an exam and use X-rays, advanced imaging, and other tests to diagnose your chronic pain issue and provide the right treatment for you.
Is Spinal Cord Stimulation Right for You?
Candidates for spinal cord stimulation often have a diagnosis of complex regional pain syndrome, a spinal cord injury, or another form of neuropathic pain (pain from spinal and nerve damage). SCS therapy is usually only considered if a patient does not achieve desired pain relief or health-related goals with conservative options. Anti-inflammatory medications, prescription pain medication, or more advanced treatments in pain medicine are often used first before your doctor will recommend an SCS implant trial.
Spinal cord stimulator implantation is a type of interventional spine surgery that may not be suitable for all patients. For instance, the implantable pulse generator, which is used as part of the SCS system, poses added risks for patients with permanent pacemakers. Other conditions and lifestyle factors may also exclude some patients from SCS implantation.
You should seek out an experienced interventional spine doctor to perform your SCS procedure. While many patients are candidates for SCS, only an experienced, skilled surgeon knows who will benefit most from the procedure. At Rebound Orthopedics & Neurosurgery, our spinal cord stimulator experts, Nicolas Karvelas, M.D., and Brian Ragel, M.D., both have exceptional training and experience in spinal cord stimulation and the latest interventional surgical procedures. Our experts are available at our Vancouver, East Vancouver, Salmon Creek, Neurosurgery Vancouver and Neurosurgery Rose Quarter locations.
What to Expect During Your Spinal Cord Stimulation Procedure
Before your stimulator is implanted, you will undergo a spinal cord stimulator trial procedure. This can be completed in the office or an operating room. Your doctor will give you local anesthesia and place temporary electrodes on tiny wires, or leads, in the epidural space of the spinal canal. You will be given a hand-held controller to regulate the electrical pulses and stimulation for pain relief. After a trial period, if the electrical stimulation has significantly helped with your pain management, your doctor will perform the permanent implantation procedure.
When a permanent spinal cord stimulator is implanted, your doctor will use local anesthesia and sedation as needed before placing leads in the epidural space. Your doctor will work with you to make sure the electrode and lead placement are appropriate for you before fixing them in place. Your doctor will then make a small incision and implant a pulse generator under your skin. After the incision is closed, you will recover while any sedation wears off, and you will be able to go home the same day. You will have follow-up visits with your doctor to ensure you are healing properly, and adjustments may be made to your SCS device so the stimulation can better control your pain.
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Cord Stimulator Procedure Recovery, Risks & Rehabilitation
After your procedure, you may need to limit movement while you heal. Light activity is usually recommended two weeks after surgery, by which time you should be able to use your spinal cord stimulator normally once any needed adjustments are made by your doctor. Other activities may be restricted for longer to avoid problems with your stimulator or leads.
As with any surgery, there is a risk of infection, bleeding, or blood clots. Lead migration and device damage are also possible with falls or intense physical activity. The implantable pulse generator should last long-term, but a second surgical procedure may later become necessary to replace the spinal neurostimulator device.
The Region's Most Preferred Interventional Spine Care in Vancouver & Portland
If you're ready to discuss spinal cord stimulator treatment options with one of our pain specialists, Nicolas Karvelas, M.D. or Brian Ragel, M.D., visit us in Vancouver at our Vancouver, East Vancouver, Salmon Creek, or Neurosurgery Vancouver locations or in Portland at our Rebound Neurosurgery Rose Quarter location. You can request an appointment online or call us at 1-800-REBOUND.