What Is Spinal Cord Stimulation (SCS)?

Spinal cord stimulation (SCS) is a non-destructive, adjustable neuromodulation technique used to reduce or eliminate chronic pain by applying electrical stimulation to the dorsal columns of the spinal cord.

During the procedure, a small electronic device is implanted near the spine to help alleviate pain. This device sends electrical impulses to the spinal cord, stimulating the dorsal column to disrupt pain signals before they reach the brain.

A pulse generator produces these electrical signals and is implanted under the skin.

Modern stimulators (often referred to as “pain pacemakers”) are rechargeable, position-sensitive (adapting stimulation based on whether the patient is lying or standing), and some models are MRI-compatible under specific settings. The programming interface offers extensive options for customization and testing to achieve optimal pain relief.

Conditions Treated with Spinal Cord Stimulation

SCS is used to treat chronic pain conditions, such as:

  • Spine-related pain (e.g., failed back surgery syndrome)
  • Nerve damage or neuropathic pain
  • Complex Regional Pain Syndrome (CRPS)
  • Other chronic neuropathic pain syndromes

When Is SCS Not Recommended?

SCS may not be suitable for:

  • Patients with unknown pain origin
  • Those with allergies to implanted materials
  • Cases where pain is due to psychological or neurological disorders

What to Expect During the Procedure

The procedure begins with general anesthesia. A needle is used to insert a trial electrode near the spinal cord through a small incision in the back. The electrode wire exits through the skin and remains in place for a 1–3 week trial period, during which the patient evaluates the effectiveness of the stimulation.

If the trial is successful—meaning the patient experiences at least a 50% reduction in pain score—the treating physician may recommend permanent implantation.

During permanent implantation, the pulse generator is surgically placed under the skin in the abdominal or lower back region. It appears as a small bulge under the skin, similar to a pacemaker. The system includes external handheld programmers, which can be adjusted by both the physician and the patient to fine-tune the strength and type of stimulation depending on the time of day and daily activities.

The procedure is typically performed on an outpatient basis and takes 1–2 hours, depending on the patient’s overall health. Patients can usually go home the same day.

After the Procedure

  • For the first few days, patients should follow a restful lifestyle, gradually increasing activity over time.
  • The position of the implanted electrode becomes stable over the following weeks to months.
  • Avoid strenuous activities and follow your physician’s instructions during recovery.

How Soon Can Pain Relief Be Expected?

Results vary from patient to patient, but most experience pain relief within the first few weeks, and improvement may continue over time. Functional improvements often accompany the pain reduction.

How Can Patients Support Their Recovery?

Patients play an active role in recovery. Strategies to improve outcomes include:

  • Weight reduction
  • Healthy diet
  • Adequate sleep
  • Doctor-recommended physical therapy exercises

Is SCS Safe? What Are the Risks?

Spinal cord stimulation is considered safe and effective, but like all medical procedures, it carries potential risks:

Possible Risks of Spinal Cord Stimulator Implantation:

  • Device malfunction: If the stimulator fails, pain relief may be lost.
  • Infection: Infection may occur along the electrode path or implantation site.
  • Bleeding: Bleeding in the spinal canal can cause compression or paralysis, requiring urgent neurosurgical intervention.
  • Allergic reactions: Rare, but possible reactions to the materials used.
  • Nerve or spinal cord injury, potentially leading to paralysis.
  • Lead migration: The electrode may shift from its original position, reducing effectiveness.
  • Implantation-related risks: Standard surgical risks, such as pain at the site, bleeding, and infection.

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