Spinal Cord Stimulation

A spinal cord stimulator, also known as a dorsal column stimulator, is an implanted electronic device used to help treat chronic pain. The primary goal of the spinal cord stimulator is to allow the patient to be more active and take less pain medication with less pain. Spinal cord stimulators can block the pain signal as it travels up the spinal cord to the brain. The small stimulator device is similar to a pacemaker and is implanted underneath the skin in the buttocks or lower abdomen. The device is then connected to electrodes that are positioned over the back of the spinal cord by wires placed inside the spinal canal. The device then delivers an electrical current to the electrodes that interrupts the pain signal, replacing pain with a tingling sensation. The stimulation serves as a distraction and allows the brain to focus on the tingling, soothing sensation. Spinal cord stimulation is considered when pain is chronic and severe, and surgeries, injections, physical therapy, medications, and other treatments have failed to give pain relief. Spinal cord stimulators serve to work best for neuropathic pain, the type of pain caused by injury or disease to the nerves. It is also used when there is continued pain into the limbs following back surgery. This condition is called Failed Back Surgery Syndrome. Before having the device implanted, patients will have to undergo a physical examination and a psychological evaluation. If the patient has a pacemaker or cardioverter defibrillator already, the spinal cord stimulator could interfere with the device and can be life threatening. The complete process is actually done in two stages. In the first stage, the trial stage, the electrodes and wires are placed into position in the spinal canal and left protruding the skin. These electrodes are then attached to an outside source. During this trial period, the patient is able to adjust the strength of the electrical stimulation from the external device. The trial usually lasts about seven days. If the trial is successful, the patient will undergo a second procedure that involves placement of electrode wires near the spinal cord. If pain is located in the arm(s), the wires are placed in the upper back. If the pain is located in the leg(s), the wires are placed in the low back. The wires will be attached to the implanted spinal cord stimulator device. The device can be programmed to adjust the type and strength of the electrical stimulation. The spinal cord stimulator is not necessarily permanent. It may be removed if necessary.