Spinal Cord Stimulation

Spinal Cord Stimulation for Chronic Pain

About Spinal Cord Stimulation

As an intervention for chronic back and/or leg pain, spinal cord stimulation can be an effective alternative or adjunct treatment to other interventions that have failed to manage pain on their own.

Spinal cord stimulation alleviates pain by electrically activating pain-inhibiting neuronal circuits in the dorsal horn and inducing a tingling sensation (paresthesia) that masks the sensations of pain.

Indications

A Medtronic implantable neurostimulation system is indicated for spinal cord stimulation (SCS) as an aid in the management of chronic, intractable pain of the trunk and/or limbs—including unilateral or bilateral pain associated with the following conditions:

  • Failed Back Syndrome (FBS) or low back syndrome or failed back
  • Radicular pain syndrome or radiculopathies resulting in pain secondary to FBSS or herniated disk
  • Postlaminectomy pain
  • Multiple back operations
  • Unsuccessful disk surgery
  • Degenerative Disk Disease (DDD)/herniated disk pain refractory to conservative and surgical interventions
  • Peripheral causalgia
  • Epidural fibrosis
  • Arachnoiditis or lumbar adhesive arachnoiditis
  • Complex Regional Pain Syndrome (CRPS), Reflex Sympathetic Dystrophy (RSD), or causalgia

Contraindications

For a complete listing of contraindications, warnings and adverse events please see the Indications, Safety & Warnings for Spinal Cord Stimulation.

References

  1. Kumar K et al. Surg Neurol. 1998:50:110-121

Treatment & Diagnosis

How Spinal Cord Stimulation Treats Chronic Pain

Spinal cord stimulation involves the delivery of mild electrical signals to the epidural space. Pain signals are “masked” by the perception of a tingling sensation (parasthesia) in the area where the pain was felt.

Published studies have shown that when used by carefully selected chronic pain patients, neurostimulation may:

  • Effectively improve pain relief (a majority of patients may experience at least a 50% reduction in pain)2-4
  • Increase activity levels2-5
  • Reduce the use of narcotic medications3-5
  • Lead to reduced hospitalizations and surgical procedures, reduced health care costs, greater independence, and improved quality of life2-4

Additionally, spinal cord stimulation offers the following advantages:

  • Screening trial allows testing of a patient's response before a full implant
  • Patient control within physician-set limits
  • Non-destructive procedure compared with surgical alternatives

References

  1. Kumar K et al. Surg Neurol. 1998:50:110-121
  2. Burchiel K, et al. Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain. Spine.1996; 21(23):2786-2794.
  3. North R, et al. Failed back surgery syndrome: 5-year follow-up after spinal cord stimulator implantation. J Neurosurg.1991; 28 (5): 692-699.
  4. North R, et al. Spinal cord stimulation for chronic, intractable pain: experience over two decades. J Neurosurg.1993; 32 (3): 384-395.
  5. Racz G, et al. Percutaneous dorsal column stimulator for chronic pain control. Spine.1989; 14 (1): 1-4.