Implantable Spinal Cord Stimulators: Relief of chronic pain

Implantable Spinal Cord Stimulators can be utilized in pain medicine to provide relief of chronic pain where all pharmaceutical therapies have failed. We have forever been frustrated by the inability to effectively treat patients who have received little or no relief from multiple back surgeries while failing response to conventional methods of pain control.
One therapy offering possible hope to a subset of these patients is Spinal Cord Stimulation. SCS is the electrical stimulation of a precise level of the spinal cord to generate parasthesia (tingling sensation) in the appropriate areas to overlay the portions of the cord producing the pain. An epidural lead is placed in the appropriate area, connected with cabling subcutaneously (under the skin) to a power source. The electrical stimulation can be externally controlled according to the needs of the patient. Operation of the system is simple enough that a majority of patients find it possible to self mange their pain.
Based on the Melzack-Wall Gate Control Theory of Pain published in 1965, SCS has evolved over the past two decades into an accepted treatment for certain intractable pain conditions. The therapy is nondestructive and reversible. The patient can be tested prior to implantation. Careful selection is essential in determining successful outcomes. Patients who respond well include those with failed back syndrome, arachnoiditis, Regional Complex Pain Syndrome, and peripheral neuropathies.
Patient selection is critical and should be limited to those who have failed more conservative therapies, further operations will not help, or demonstrate radiating pain in their extremities. With careful selection, 60-70% of SCS patients experience good to excellent pain relief, reduction in narcotic or analgesic intake, and improved activity. Most importantly, the patients report they are able to move toward a more normal lifestyle.

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