Spinal cord stimulation (SCS) involves the implantation of one or more electrodes into the epidural space—the area that spans the entire length of the spinal cord and lies between the bony vertebrae and the spinal cord.
These electrodes are implanted at the level of the spine where chronic pain is localized and are connected to a small electrical generator, which is also implanted subcutaneously beneath the fatty tissue making it invisible.
The generator produces electrical signals that are transmitted to the electrodes, which in turn stimulate the spinal cord at the location of pain.
This stimulation alters the way pain signals are transmitted from the spinal cord to the brain, effectively “shutting off” the pain sensation.
This same technique can be applied not only on the spinal cord but also to peripheral nerves that are affected, using the same mechanism of action.
This method has shown promising results in the treatment of chronic conditions like sciatica, diabetic peripheral polyneuropathy, postherpetic neuralgia which occures from a previous shingles infection, and peripheral nerve injuries.
Due to its invasive nature, it is typically recommended for patients in whom oral medications, even at the maximum safe dosage, are ineffective or cause intolerable side effects.
In addition it is used in patients who, for various reasons, cannot or do not wish to undergo surgery, or those who have had previous surgeries or less invasive treatments that failed to provide satisfactory relief from their symptoms.
The implantation of electrodes is performed under local anesthesia and fluoroscopic (X-ray) guidance to ensure precise placement.
The implanted generator has specific settings for the stimulation parameters, such as the intensity and frequency of the electrical impulses.
These parameters are programmed in advance by the physician but can be adjusted as needed, using special external equipment, without the patient needing to undergo any further procedures.
In addition, the patient is provided with a remote control that allows them to adjust the intensity or frequency of the stimulator if they feel their pain is not adequately controlled.
This gives the patient the ability to self-regulate the treatment based on their daily activities and pain levels, offering a level of control over their pain management.
This technique provides a non-invasive option for managing chronic pain, with flexibility for patients to adjust their treatment as needed. Let me know if you need any further clarification!
