Midwest Spine Institute FAQ's
Spinal Cord Stimulator FAQ
Q: What is a Spinal Cord Stimulator?
A: Spinal Cord Stimulator (SCS) is a specialized device, which stimulates nerves by tiny electrical impulses via small electrical wires placed on the spinal cord. It also is called a Dorsal Column Stimulator, Neurostimulator, or Neuromodulation device.
Q: Am I a candidate for Spinal Cord Stimulator?
A: Midwest Spine Institute offers in-office Spinal Cord Stimulator trials to patients with chronic and severe pain, who have not responded to other treatment modalities. Most of these patients are suffering from back and/or leg pain after back surgeries, chronic radiculopathy, neuropathic pain, or RSD (Reflex Sympathetic Dystrophy) or CRPS (Complex Regional Pain Syndrome)
Q: Will the Spinal Cord Stimulator help me?
A: It is very difficult to predict if the procedure will indeed help you or not. For that reason temporary wires are placed to determine if this device will be effective to relieve your pain or not. Typically, patients will have a 50 to 70 % reduction in their pain.
Q: What is the purpose of a Spinal Cord Stimulator?
A: This device interrupts nerve conduction (such as conduction of pain signals) to brain. One patient described it this way:
Testimonial:
”My doctor explained that [SCS] is a little bit like tricking your body: You’re going to keep your pain, but your brain is not going to know about it. Basically, we are going to change your pain sensation to feel like bubbles or sparkles. And my doctor said that’s why we have a trial session.”
—Monica Cienfuegos
Spinal Cord Stimulator Patient
Q: How long does the Spinal Cord Stimulator procedure take?
A: It is done in two stages. In the first stage, temporary wires are placed and an external device is used by the patients to generate electrical current for 4-7 days. If this trial is successful in relieving pain, then the permanent device is placed under the skin. The first stage takes place in the office setting in the procedure area. This usually takes 45 min – one hour. The second stage procedure can take up to 2-3 hours and is done in the outpatient surgery center at a local hospital.
Q: How is the Spinal Cord Stimulator procedure actually performed?
A: The wires are placed under x-ray guidance and a local anesthetic is used to numb the skin and deeper tissues. The final implant procedure is performed in the operating room to maintain sterility.
Q: Will the Spinal Cord Stimulator procedure hurt?
A: The procedure involves inserting a needle through skin and deeper tissues (like a "tetanus shot"). So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate.
Q: Will I be "put out" for a Spinal Cord Stimulator procedure?
A: The placement of the wires is done under local anesthesia with patients mildly sedated. This is necessary to ensure proper placement of the wires. The amount of sedation given generally depends upon the patient tolerance. For the generator placement, patients are given stronger intravenous sedation.
Q: How is the Spinal Cord Stimulator procedure performed?
A: It is done with the patient lying on the stomach. The patients are monitored with heart rate, blood pressure cuff and blood oxygen-monitoring device. The skin is cleaned with antiseptic solution and then the procedure is carried out. X-ray (fluoroscopy) is used to guide the needle for wire placement.
Q: Where are the wires inserted in the Spinal Cord Stimulator procedure?
Where is the generator placed?
A: For the pain involving lower back and lower extremities, the wires are inserted in the midline at the lower back. The generator is then placed on the side of the back or upper hip area.
Q: What should I expect after the Spinal Cord Stimulator procedure?
A: If the procedure is successful, you may feel that your pain may be gone or quite less. You will experience a fairly constant sensation of stimulation. You may have soreness due to the needles used for a day or two.
Q: What should I do after the Spinal Cord Stimulator procedure?
A: This procedure is normally a day-procedure. Some patients may be kept overnight for observation. This is rare. You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you. You will be provided specific instructions for home care.
Q: How long will the generators last for the Spinal Cord Stimulator?
A: Depending upon how much the device is used (intensity and duration); the batteries in the generator may last many years. We will discuss the type of battery and the expected length of time it will last and how to replace it at the consultation.
Q: What are the risks and side effects of a Spinal Cord Stimulator?
A: Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. Please discuss your concerns with your physician.
Q: Who should not have a Spinal Cord Stimulator procedure?
A: If you are on a blood thinning medication (e.g. Plavix, Coumadin®), you will need to temporarily be off these medications. You will need to be off your Coumadin (warfarin) for 5 days to get your INR level <1.4. You will need to be off your Plavix (clopidogrel) for 7 days. Then you may have the procedure. We will postpone a trial or implant if you have an active infection going on. Also, if you are cognitively impaired due to trauma or memory loss and do not have someone to help you with the stimulator the system may be too overwhelming to manage.
Q: Where can I get additional information about a Spinal Cord Stimulator?
A: More detailed information is available from the manufacturer of this device. We can also have you speak with a former patient if you would like to get a first hand perspective on the process. At the time of consultation you will receive a Spinal Cord Stimulation Patient Education Booklet. Additional information is also available at Boston Scientific Website Web Site @ http://www.controlyourpain.com and St. Jude Medical web site @ www.poweroveryourpain.com
Q: Can spinal cord stimulation therapy be stopped?
A: Yes. If you receive an implanted system and no longer require it for pain relief or change your mind about the therapy, it can be turned off, and the device can be removed. Again, this is a reversible and minimally invasive therapy.
Q: Can I take pain medications during the screening test for a Spinal Cord Stimulator?
A: Your physician may withdraw oral pain medications 1 or 2 weeks prior to the screening test. However, you may be given oral medication during the screening test for breakthrough pain. Never stop taking your prescribed pain medication without first consulting your physician.
Q: Can I take pain medications during the screening test for a Spinal Cord Stimulator?How long will I have to wait until a spinal cord stimulation system is implanted?
A: If you and your physician decide spinal cord stimulation therapy is right for you, Dr. Locketz will discuss when a permanent system should be implanted. Insurance considerations, including the amount of time to get coverage approved, may significantly affect scheduling for a permanent spinal cord stimulation system.
Q: Will a spinal cord stimulation system provide the same pain relief as the temporary system?
A: Your pain relief may differ slightly but it should be very similar. This is because the leads may be placed in a slightly different location than during the screening test. Your physician can adjust your neurostimulator so it delivers the best pain relief possible. Be sure to tell your physician about the way you feel, so that changes can be made that will optimize therapy.
Q: Will spinal cord stimulation therapy completely eliminate my pain?
A: Many people experience significant improvements in their pain symptoms and quality of life after receiving spinal cord stimulation therapy. However, not everyone responds to spinal cord stimulation therapy in the same way, and your experience may vary. Your spinal cord stimulation system will not provide relief from other types of pain such as headaches, abdominal pain, pain from fractures, etc.
Patient Experience
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