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Spinal Cord Stimulation

What is a Spinal Cord Stimulator (SCS)?
Spinal cord stimulator (SCS) is a device, which delivers low voltage electrical stimulation to the spinal cord. The electrical stimulation to the spinal cord is delivered through one or two wires, which are carefully placed in the epidural space. The epidural space is a space adjacent to the spinal cord.

How does it work?
The electrical signals sent by spinal cord stimulator replace the sensation of pain with a tingling sensation.

How is the procedure performed?
Illustration: Spinal Cord StimulationThe spinal cord stimulator is implanted in two stages. The first stage is a trial and it is performed in the operating room with local anesthetic and intravenous sedation. In this stage, we place the wires through the skin, into the epidural space, which is adjacent to the spinal cord. Then the wires are connected to a stimulating generator. We leave the wires in place for a week. This is really a test to determine if a permanent stimulating generator should be used. If the trial is successful, we place a permanent generator under the skin. The procedure is performed in the operating room.

What are the benefits of SCS?
The goal of the implantation of a spinal cord stimulator is to reduce rather than eliminate pain.

Who is an appropriate candidate for SCS?
A patient with certain chronic pain conditions including: neuropathic pain, failed back surgery syndrome, complex regional pain syndrome, arachnoiditis, and certain types of vascular disease.

What are the risks of the procedure?
The serious side effects and complications are uncommon. The most common problem is having pain at the site of insertion of the wires and generator for a few days after implantation. The other complications are infection, bleeding, nerve injury, spinal cord injury, dural puncture or tear, and migration or breakage of the wire.

Do I hear or feel the system inside me?
The spinal cord stimulator does not make any noise. It might be felt as a large lump under the skin. It does not normally show through street clothes.

What should I do if any problems develop after I leave the hospital?
Call the pain clinic at (603) 650-6040, Monday through Friday 8 am to 5 pm. After these hours call the hospital operator at (603) 650-5000 and ask for the pain clinic physician on call.

Will I be able to control the spinal cord stimulator?

What are restrictions after the implantation of spinal cord stimulator?
You should follow your physician's instructions for activity restrictions. During the first ten to 12 weeks following the implantation, you will need to avoid lifting, bending and twisting movements.

Who should not have the procedure?
If you are taking blood thinners (Coumadin, Plavix, Ticlid or others) or antibiotics, have an active infection, or have a bleeding disorder you should not have the procedure without further discussion. Please warn us of any allergies you have, especially to local anesthetics, X-ray dye and latex. You must also avoid certain medical procedures (e.g., magnetic resonance imaging, MRI) and take special precautions with electronic systems and items that contain magnets.

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