![]() The mechanism of action of SCS would be based on the antidromic activation of the dorsal column fibers, which activate the inhibitory interneurons within the dorsal horn. In spite of the existence of several studies that try to prove the mechanism of action of SCS, it still remains unknown. This article is a non-systematic review of the mechanism of action, indications, results, programming parameters, complications, and cost-effectiveness of SCS. Following that, technological progress, among other advances, helped SCS become an effective tool to reduce pain. Overall, it is a safe procedure in the hands of an experienced physician and needs minimum maintenance and supervision by a physician after the implantation unlike the morphine pump that requires refills in the physician’s office.Spinal cord stimulation (SCS) has been used to treat neuropathic pain since 1967. In some patients, a pad leads are implanted by a surgical incision around the spine. The patient may need a revision of the neurostimulator to reposition the electrodes. The electrodes may move or dislocate in the epidural space that can result in loss of stimulation in the painful area. In that case, mostly the implanted hardware (electrode and batteries) are taken out to treat the infection Patient may develop infection after the implantation. Possible complications of Dorsal Column Stimulator Placing the charger over the skin usually once a week charges the battery. The new generation rechargeable batteries can last up to seven to nine years. The batteries are implanted on the back of the patient below the belt-line. The electrodes are placed around the epidural space through a needle and a small incision is made to implant the electrodes and the stimulator batteries under the skin. The placement of permanent stimulator is performed in the operation room under light sedation. Other patients may be able to cut down the oral opioids and might be able to do a lot of functional activities that they could not perform before the placement of the temporary electrodes. A patient should report at least 50% improvement in their pain levels. If patient has a significant improvement during the trial period, they will qualify for the permanent implantation of neurostimulator. Candidates for permanent placement of neurostimulator The leads are taken out in the office without any significant discomfort to the patient. I usually encourage my patients to stay active and even go to work during the trial period so that they can have a clear idea of how much this device makes them functional and productive. The patient is sent home from the surgery center or physician’s office to use it for, on average, four to five days on a trial basis. The cables are then connected to an outside battery-powered programmer. Trial of dorsal column stimulatorĪ temporary electrode is placed in the epidural space through a needle under fluoroscopy with a light sedation. The patient undergoes psychological screening to be qualified for the procedure and it is a two-phased procedure. Chronic intractable pain that fails to respond to traditional oral medications, and physical treatment modalities.It replaces pain with pleasant electrical stimulation. Neurostimulation is like a small TENS unit implanted on the spinal cord or peripheral nerve. When these devices are used properly, they can be beneficial to the society and can provide outstanding clinical and economical benefits. Recent advancements in technology and physiological research have helped to create neurostimulators for pain control. ![]()
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