What is Spinal Cord Stimulation?

By Laxmaiah Manchikanti, MD and Mahendra Sanapati, MD



Spinal cord stimulation is the use of a stimulator to send electrical signals to areas of the spinal cord for the treatment of pain.

How does it work?

   Spinal cord stimulation works by sending small electrical impulses to your spinal cord. An electrode is placed over the spinal cord and is powered by a stimulator which is implanted in the buttocks or abdomen. Stimulation helps to block the pain signals traveling to the brain.

What kind of pain does a spinal cord stimulator help?

   Those suffering with chronic pain have probably had many alternative treatments without long-lasting or inadequate effectiveness. Spinal cord stimulators may be used for the treatment of chronic and intractable pain, including:

1.   Post-surgery syndrome

   (called failed back surgery syndrome)

2.   Complex regional pain syndrome         

(was called Reflex Sympathetic Dystrophy, or RSD)

3.   Nerve-related pain including:

   -   Diabetic neuropathy

   -   Radiation neuropathy

   -   Chemotherapy neuropathy

   -   Neuropathy after exposure to chemicals

4.   Phantom limb pain

5.   Ischemic limb pain

6.   Chronic pain

What is the procedure for spinal cord stimulator?

   A spinal cord stimulator is surgically placed under your skin usually near the buttocks or abdomen. It sends a mild electric current to your spinal cord. Thin wires carry current from the stimulator to the nerve fibers of the spinal cord. Spinal cord stimulators allow patients to send the electrical impulses using a remote control when they feel pain.

What are the steps for placement of the

Spinal cord stimulators?

1. Trial

Initially, a trial is performed by placing and leaving the stimulator in for several days to determine the acceptability and the pain relief obtained. This is performed as a sterile surgical technique without any incisions.

2. Permanent surgery

If the patient experienced good pain relief without any side effects, a permanent stimulator will be placed in the mid back area. Under x-ray guidance, two electronic leads are placed in the mid-back or higher depending on the source of the pain. The leads are tunneled and connected to the stimulator located in the low back area, abdominal area or over the hip.

What is the selection criteria?

   Selection criteria for spinal cord stimulation trial and surgery are very stringent. Suitability of the procedure is judged by:

1. Physical condition

2. Psychological status

3. Relief obtained from the trial.

Are there any restrictions after a

spinal cord stimulator implant?

   After both the trial and permanent surgery, try to limit physical activity. This includes exercise or any work that involves twisting, stretching, or reaching overhead. These actions can cause your stimulator leads to move away from the treatment area.

Can you live a normal life with a spinal cord stimulator?

   Living with a spinal cord stimulator for many people means living with less than half the pain they experienced in the past. That’s the short answer, but it holds true for the majority of patients who are good candidates for spinal cord stimulation.

Meeting the health needs of patients without regard to race, color, religion, sex, age, or national origin

Dr. Manchikanti on Spinal Cord Stimulation

Click to view a short video: https://youtu.be/-F1qzeWrRkQ