A spinal cord stimulator (SCS) implant is a medical device designed to manage chronic pain that has not responded to other treatments. This neuromodulation device works by sending mild electrical impulses to the spinal cord, which then interfere with or modify pain signals traveling to the brain. The system typically consists of thin wires, called leads, placed near the spinal cord and connected to a small battery-powered generator implanted under the skin. Spinal cord stimulation aims to provide significant pain relief, allowing individuals to improve their daily function and quality of life. It is often considered for conditions such as failed back surgery syndrome, complex regional pain syndrome, and neuropathic pain.
Pain During the Implantation Process
The process of receiving a spinal cord stimulator involves two main stages: a trial period and, if successful, the permanent implantation surgery. During the trial, thin leads are temporarily placed in the epidural space near the spinal cord, connected to an external battery pack. This procedure is generally performed under local anesthesia with sedation, allowing the patient to remain comfortable but awake enough to provide feedback on the stimulation sensations. Patients might experience some pressure or mild discomfort during lead placement, but significant pain is actively managed through anesthetic techniques.
The trial typically lasts for several days to a week, allowing both the patient and the medical team to assess the device’s effectiveness in reducing pain. If the trial demonstrates at least 50% pain relief and improved function, the patient may proceed to permanent implantation. The permanent surgery involves implanting the leads and a pulse generator, often in the abdomen or buttock, under local anesthesia with sedation or general anesthesia.
During the permanent implant procedure, patients might still feel sensations like pressure or movement as the leads and generator are positioned. While some brief, sharp feelings can occur, the use of anesthesia aims to minimize discomfort. The surgical team continuously monitors the patient to ensure comfort and can adjust sedation as needed.
Post-Procedure Recovery and Sensations
Following the permanent spinal cord stimulator implantation, patients typically experience some post-operative pain at the incision sites. This discomfort is comparable to what might be expected after any minor surgical procedure. The primary incision is usually in the back where the leads were inserted, and another incision may be present where the battery (pulse generator) was implanted, often in the lower abdomen or upper buttock.
Acute pain at these sites is managed with prescription pain relievers, and applying ice packs can help reduce swelling and discomfort. This surgical pain usually subsides within a few days to a couple of weeks as the incisions heal. Patients are advised to avoid strenuous activities and heavy lifting during this initial recovery period to allow proper healing and prevent lead migration.
Once the incisions have healed, and the device is activated, patients begin to experience the electrical sensations from the stimulator. These initial sensations are often described as a tingling, buzzing, or vibrating feeling, known as paresthesia. The medical team works with the patient to program the device, adjusting the settings to optimize pain coverage with these non-painful sensations. This fine-tuning ensures the stimulation effectively masks the chronic pain without causing new discomfort.
Living with the Device: Comfort and Relief
Living with a spinal cord stimulator involves adjusting to the consistent electrical sensations, which ultimately work to provide long-term pain relief. The SCS reduces pain through paresthesia, a tingling or buzzing sensation. This sensation is not painful; it masks chronic pain signals. Patients are taught to adjust the intensity of the stimulation using a handheld controller to best cover their pain.
Many individuals report being able to engage in activities they previously found difficult or impossible due to pain. The device can also reduce reliance on oral pain medications, including opioids, which carry their own risks and side effects.
While the paresthesia is generally well-tolerated, some patients might occasionally feel the implanted device under their skin, especially if it is placed in an area with less tissue. This sensation is usually minor and does not cause significant discomfort. Modern SCS devices are designed to be compact and are often placed in discreet locations to minimize such feelings.