What Is Spinal Cord Stimulation?
Spinal cord stimulation (SCS) is an advanced, reversible neuromodulation therapy that delivers mild electrical impulses to the spinal cord to modify pain signal processing before signals reach the brain. It is one of the most effective treatments available for complex chronic pain conditions — particularly those that have not responded adequately to medications, injections, or prior surgery.
Unlike treatments that target a single anatomic structure, SCS works at the neural level by altering how pain signals are processed in the spinal cord and brain. Modern SCS systems use sophisticated waveforms (high-frequency, burst, or closed-loop stimulation) that provide pain relief without the paresthesia (tingling sensation) associated with older systems. Dr. Qureshi works with patients to determine candidacy and facilitates the full SCS evaluation and trial process.
Conditions Treated
- Failed back surgery syndrome (FBSS) — persistent pain after spinal surgery
- Complex regional pain syndrome (CRPS) Type I and II
- Refractory diabetic peripheral neuropathy
- Refractory angina and ischemic limb pain
- Chronic intractable low back and leg pain
- Post-laminectomy syndrome
- Arachnoiditis
- Peripheral neuropathy
How It Works
SCS works through a mechanism called neuromodulation — modifying neural activity rather than destroying tissue. The implanted leads deliver electrical pulses to the dorsal columns of the spinal cord, which activates large-diameter inhibitory fibers (A-beta) that suppress the smaller pain-transmitting fibers (C and A-delta). Modern high-frequency and burst SCS systems achieve pain relief through additional central mechanisms that reduce central sensitization — the "volume knob" phenomenon that amplifies chronic pain.
The process begins with a trial period: temporary leads are placed and connected to an external generator for 5–7 days. If the trial achieves 50% or greater pain reduction, the system is implanted permanently in an outpatient procedure.
Benefits
- Significant pain reduction in 70–80% of appropriate candidates
- Reduced dependence on opioid and other pain medications
- Improved physical function and quality of life
- Reversible — the system can be removed if needed
- Rechargeable batteries lasting 8–10 years
- MRI-compatible systems now available
- Insurance-covered for most appropriate indications
Risks & Side Effects
- Temporary soreness at implant site (post-surgical)
- Lead migration requiring repositioning (rare with proper technique)
- Device-related issues (rare with modern systems)
- Infection risk (minimized with proper surgical technique)
- Requires psychological evaluation before implantation as part of standard criteria