Q   What is  a spinal cord stimulator (SCS) ?

Spinal cord stimulator is an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain. Spinal cord stimulators consist of thin wires ( electrodes) and a small pacemaker-like battery pack ( generator). The electrodes are placed between the spinal cord and the vertebrae (epidural space), and the generator is placed under the skin, usually near the buttocks or abdomen. Spinal cord stimulators allow patients to send the electrical impulses using a remote control when they feel pain. Both the remote control and its antenna are outside the body.

Q What exactly does a spinal cord stimulator do? 

Spinal cord stimulator targets multiple muscle groups directly from the spine and  alter how the brain senses pain. A spinal cord stimulator replaces the sensation of pain with light tingling feeling.

Q What conditions are spinal cord stimulators used for?

Spinal cord stimulators are used often when most  pain treatment options have failed to provide sufficient relief. Spinal cord stimulators may be used to treat or manage different types of chronic pain, including : Back pain, especially back pain that continues even after surgery (failed back surgery syndrome) ,Post-surgical pain, Arachnoiditis ,Heart pain untreatable by other means ,spinal cord injuries, Nerve pains (like diabetic neuropathy , and cancer-related neuropathy from radiation, surgery or chemotherapy),Peripheral vascular disease, CRPS -Complex regional pain syndrome, Post amputation pain and Visceral abdominal pain and perineal pain

Q Is SCS a major surgery?

No , SCS is not a major surgery. A SCS placement is done in  two phases- a trial period in which the  Interventional pain specialist  implants  temporary wires inside the epidural space of the spine  to find out how the device  may provide the pain relief. This trial procedure requires only a small incision in your lower back to place the electrodes. The generator/battery remains outside the body, typically on a belt, worn around the patients  waist. Pain relief is  evaluated over a week. The trial is considered a success if the patient  experiences a 50% or greater reduction in pain level. Thereafter intervention is scheduled to permanently implant the device. Most patients can go home same day as their procedure . In most cases, incisions heal within about 2-4 weeks after the procedure.

Q Can we live a normal life with spinal cord stimulator device ?

1-2 weeks after the procedure one can return to work, bath and swimming is fine with a permanent, implanted generator, but not with a temporary stimulator.

Q Can I drive and travel with SCS device ?

SCS should be powered off  while driving or operating heavy machinery, as sudden changes in stimulation levels can cause distraction.

Q How long does the battery of spinal cord stimulator last?

The longevity of the battery life varies between different brands and depends on device model and hours of usage per day . Overall performance of a rechargeable battery device  comes 5 to 9 years.

Q What are the precautions after spinal cord stimulator placement ?

After surgery, the  incision may be painful which may require some painkiller medications. Avoid climbing,  stretching or  twisting , bending movements  which could pull at the incisions. Dressings  over the incision sites, can be removed after about 3 days. lighter activity is recommended for about 2 weeks after surgery. Do not lift objects more than 2.5 kgs weight.

Q What is the pain relief expected with spinal cord stimulator?

The pain relief with spinal cord stimulator varies among different patients .For some it may control the pain completely requiring no pain medications at all while for others it may relieve pain and reduce the medication dose requirement.

Q Does  paresthesia with spine stimulators disturb sleep?

Spinal cord stimulation can improve overall quality of life and sleep. It is typically used along with other pain management treatments, including medications, exercise, physical therapy and relaxation methods.

Q Can I undergo MRI with SCS device?

No, MRIs are not always safe for those with spinal cord stimulation devices. Some newer devices are compatible with certain MRI machine models and scan locations. If the device is  NOT MRI compatible, MRIs can cause serious injury. interfere with or harm your stimulator mode .Before undergoing any scan, always let your doctor, nurse or technician know you have a spinal cord stimulator. SCS in  power off mode is safe to undergo, X-rays and CT scans .

Q Can I have normal sexual life with neuromodulator devices like spinal cord stimulator?

Yes ,one can have completely normal sexual life while using neuromodulatory devices like SCS, infact there have been reported cases of patients treated for sexual dysfunction with SCS.

Q I have paraplegia, can spinal cord stimulator, improve my motor functions?

Recent studies have  demonstrated impressive improvements in muscular control of standing and stepping, restoring hand and arm function after spinal cord injury. Though further research and data needs to be collected to conclude it.

Q Can Neuromodulation devices cure the disease?

Neuromodulation has shown promising results in the treatment of Obstructive sleep apnoea, neurogenic bladder , schizophrenia, faecal incontinence, depression and sexual dysfunction.