Neural stimulation, also known as Spinal cord stimulation
(SCS), or dorsal column stimulation, is an advanced
treatment for certain types of chronic pain. SCS is
actually one of a number of medical therapies in a broad
category of medical devices called neurostimulators.
Over the last 20 years, thousands of people with severe
chronic pain have received pain relief with spinal cord
SCS uses a small implanted device - called a pulse generator
or receiver - to generate low-level electrical impulses
to stimulate targeted nerves along the spinal cord.
The stimulation interferes with the transmission of
pain signals to the brain. When successful, painful
sensations are replaced with what some patients describe
as a more pleasing sensation, called paresthesia.
COMPONENTS OF AN SCS SYSTEM
To understand how spinal cord stimulation works, it
is helpful to understand the different components of
the two different types of SCS systems - IPG and RF.
The first type of system is an Implantable Pulse Generator
(IPG). An IPG's power source consists of a battery and
related electronics that are housed in a single metal
container. The IPG is completely implanted under the
skin in a practical location agreed upon by you and
your physician (e.g., the abdomen, just below the beltline
and above the buttocks, etc.). Leads are placed over
the spinal cord and connected to the IPG. It is important
to note that from time to time a surgical procedure
is performed to replace the IPG with a new one because
the battery has become depleted.
The second type of system is a Radio
Frequency (RF) spinal cord stimulator. RF spinal cord
stimulators are similar to IPGs except the battery that
supplies the power is a rechargeable, cell-phone type
battery that is located outside the body, contained
in a small controller called a transmitter. The transmitter
delivers radio waves through the skin to an implanted
receiver. The receiver in turn sends the mild electrical
energy to the leads.
HOW SCS WORKS
The implanted components of the SCS system are placed
during a surgical procedure, which, depending on the
type of leads placed, can be brief and minimally invasive.
The leads are positioned in the space above the spinal
cord (called the epidural space). The IPG or receiver
is placed just under the skin in a practical location
that is acceptable to you and your physician. The leads
are then connected to the IPG or receiver. When the
power source is turned on, the electrodes on the leads
will stimulate specific nerve fibers that affect the
areas of your pain. The stimulation of these targeted
nerves is intended to change how the brain perceives
the pain signals. Instead of feeling pain, a different
sensation is felt in areas that normally hurt. Most
patients say this new sensation feels like tingling.
The medical term for this sensation is paresthesia.
WHO SCS CAN HELP
Spinal cord stimulation is approved to treat chronic
pain of the trunk and/or limbs. It is most effective
in relieving persistent or severe neuropathic pain.
This type of pain can be caused by injury to nerves
and is often felt as an intense burning or stabbing
pain. Neuropathic pain can be very stubborn and disabling
since it often does not respond effectively to many
Spinal cord stimulation is not a treatment option for
everyone. Remember, SCS is considered an advanced pain
treatment, which means that SCS is generally not considered
an option until more conservative, and/or less expensive
pain therapies have been tried and failed to adequately
control your pain. These therapies include bed rest,
over-the-counter pain relievers, NSAIDs, nerve blocks,
opioids and perhaps, corrective surgery.
A number of other factors also affect whether you are
a good candidate for SCS. These include your diagnosis
and medical history, as well as the severity, location
and type of pain. Successful SCS therapy also requires
that you be a willing partner in the therapy. An open
and honest dialogue with your physician and your family
will help you to determine if SCS is an option for you.
here to download a Spinal Cord Stimulation Information
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