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What is A Spinal Cord Stimulator?


What is a spinal cord stimulator? 

A spinal cord stimulator is an implanted device that helps people suffering from symptoms of a wide range of conditions manage the pain and increase activity. This can be especially helpful for people trapped in a cycle of worsening pain and associated mental health problems. By finding sufficient relief to engage in daily activities and complete other treatments like physical therapy, affected patients can increase their overall health and achieve long-term relief.

Take some time to read this quick guide prepared by the USA Spine Care Team for a better understanding of what a spinal cord stimulator is. You can also learn more about how it works and how pain specialists, physicians and surgeons implant them. We’re here to help and welcome you to reach out at any time if you have questions or would like to learn more.

Primary features of a spinal cord stimulator

The main features of a spinal cord stimulator are a battery pack or generator, small thin wires attached to electrodes and a control device. The generator sends a gentle electrical pulse through the wires to the electrodes that are usually attached to the epidural space directly around the spinal cord. The implanted device can receive a signal from the external controller that the patient uses to control the pulses.

What is a spinal cord stimulator used for?

Spinal cord stimulators can treat pain related to a number of conditions. This includes chronic back pain caused by a spinal cord injury or degenerative condition like a bulging or herniated disc. Another common condition stimulators can help with is arachnoiditis, which is painful inflammation of the arachnoid membrane that surrounds the spinal cord. Spinal cord stimulators are often commonly used to relieve pain and complications associated with an unsuccessful back surgery, especially when a follow-up procedure is undesired or not viable.

Additionally, spine stimulators can relieve a number of non spine-related sources of chronic pain, including diabetic neuropathy, cardiovascular pain such as angina, complex regional pain syndrome and even abdominal pains. This is because the spinal cord is the primary conduit of the nervous system and controls how pain signals reach the brain.

How does a spinal cord stimulator help patients with chronic symptoms manage the pain?

Medical researchers are still working to fully understand how spinal cord stimulators relieve pain, but there is growing evidence that it is effective. The most common theory is that the electrical impulses disrupt pain signals, essentially confusing the brain. Many patients report a gentle tingling sensation that replaces the sensation of pain. By overriding the symptoms, people with spinal cord stimulators are generally able to manage the pain more effectively.

Specific chronic pain symptoms a spinal cord stimulator can help with include:

  • Shooting pain
  • Numbness and pins and needles sensations
  • Muscle aches
  • Burning sensations

Spinal stimulation therapy can also help patients get the exercise and therapy needed to overcome other issues like muscle weakness and fatigue. It can also improve sleep quality, which is a key factor in successful pain management.

What types of pain specialists can implant spinal cord stimulators?

Patients can find out about spinal cord stimulators through a variety of methods, from independent research, to working with their primary care physician or a pain specialist. Although spinal cord stimulator procedures are even less involved than other minimally invasive spine procedures, they are still typically performed by experienced spinal surgeons.

When meeting with a surgeon to determine if you are a potential candidate for a spinal cord stimulator, expect a review of your medical and treatment history including diagnostic imagery and a thorough discussion of your symptoms and how they’re affecting your lifestyle.

How do I find out if a spinal cord stimulator is right for me?

If a surgeon or other pain specialist determines you may benefit from a spinal cord stimulator, the next step is a trial period. This involves a very minor procedure to attach the electrodes near the spinal cord without implanting the generator. Instead, the lead wires are connected to an external device.

Patients are then given instructions on adjusting the impulses and asked to record symptom relief as they go through their day. The surgeon can then use this information to work with the patient to decide if a permanent implanted device would offer lasting pain relief.

What is a spinal cord stimulator procedure typically like for patients?

Spinal cord stimulator surgery is a relatively short, outpatient procedure. Often, it is performed at an ambulatory surgery center, helping patients avoid hospital-associated costs and infection risks. In this procedure, the surgeon will use X-ray guidance to permanently attach the electrodes and carefully tunnel the wiring under the skin. Then, using a small incision and muscle-sparing techniques, he or she will place the generator. Common locations include the lower back near the buttocks and the abdomen.

Upon recovery, the treatment team will then provide thorough instructions for the rehabilitation timeline and safe operation of the spinal cord stimulator.

Get more information on spinal cord stimulator procedures today

USA Spine Care has a highly skilled and experienced team committed to helping patients overcome chronic pain. Our spinal cord stimulator procedures are performed at our state-of-the-art outpatient centers with a streamlined patient experience designed for your comfort and convenience. To learn more about becoming a candidate for one of our procedures, contact us today.

Call toll free 1-866-249-1627.

Spinal Cord Stimulator - People Also Ask

Spinal cord stimulator implants are covered by Medicare and are billed under:

  • Percutaneous Leads and Extensions
    63650 Percutaneous implantation of neurostimulator electrode array, epidural
    63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
    63663 Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
  • Paddle Leads
    63655 Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural
    63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
    63664 Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
  • Stimulators
    63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
    63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver
  • Analysis and Programming
    CPT codes 95970–95973 are used to report electronic analysis services. These are not considered medically necessary when provided at a frequency more often than once every 30 days. More frequent analysis may be necessary in the first month after implantation.

Published studies of spinal cord stimulation show good to excellent long-term relief in 50 to 80% of patients suffering from chronic pain. One study reports that 24% of patients improved sufficiently to return to gainful employment or housework with stimulation alone or with the addition of occasional oral pain medication.

Unlike a spinal fusion, a spinal cord stimulator surgery is reversible. If a patient decides at any time to discontinue, the electrode wires and generator can all be removed.

Spinal Cord Stimulation is an option for those suffering from chronic, intractable pain of lower back and/or limbs including unilateral or bilateral pain associated with the following conditions:

  • Failed Back Surgery Syndrome (FBSS)
  • Radicular pain
  • Post-laminectomy pain
  • Multiple back surgeries resulting in continued or worsening pain
  • Unsuccessful vertebral disk surgery
  • Degenerative Disk Disease
  • Peripheral causalgia
  • Epidural fibrosis
  • Arachnoiditis
  • Complex Regional Pain Syndrome (CRPS)
  • Causalgia

No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. Specific complications related to SCS may include:

  • Undesirable changes in stimulation (can possibly be related to cellular changes in tissue around electrodes, changes in electrode position, loose electrical connections, and/or lead failure)
  • Epidural hemorrhage, hematoma, infection, spinal cord compression, and/or paralysis (can be caused by placing a lead in the epidural space during a surgical procedure)
  • Battery failure and/or battery leakage
  • Cerebrospinal fluid leak
  • Persistent pain at the electrode or stimulator site
  • A pocket of clear fluid (seroma) at the implant site. Seromas usually disappear by themselves but may require a drain.
  • Lead migration, which can result in changes in stimulation and reduction in pain relief
  • Allergic response to implant materials
  • Generator migration and/or local skin erosion
  • Paralysis, weakness, clumsiness, numbness, or pain below the level of implantation

In a spinal cord stimulator trial, temporary electrodes are placed and then the patient uses an external device to generate electrical current. The electrodes are placed under x-ray guidance with the patient lying on his belly. A local anesthetic is used to numb the skin and deeper tissues. The electrical wire or lead contains a series of four to eight evenly spaced electrodes that can be programmed to generate an electrical field. A spinal cord stimulator trial period is at least 5 to 7 days. This gives you time to test the device and evaluate its effectiveness managing your pain at rest and during activity

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