What is SCS?
Chronic severe pain can be controlled by transmitting low voltage electric current to the spinal cord.
The principle of action is as follows: An electrode is placed on the relevant epidural area and low voltage electric current is generated by a device placed under the skin.
How is SCS Performed?
This intervention is performed in the operation room. The patient lays on the side in a facedown position and the target area is accessed by a needle by the help of a scopy. The electrode is passed through the needle and reaches the spinal cord under scopic control. Various stimulation modes are tried to find the best coverage for the painful area. Transient electrodes are placed and the outer part of the electrodes is connected to the test stimulator. Then the patient is followed for 1-3 weeks and when there is at least 50% decrease in the pain complaint, the test stimulator is removed and the permanent stimulator is placed under the skin through a small incision line.
Preparations before the procedure:
- The patient should have no infection.
- Anticoagulants should not be taken and the patient should abstain using such drugs with the relevant physician’s approval.
- No food or water should be taken for at least 4-6 hours before the intervention (4-6 hours fasting).
- The area of mechanical access should be free of any infection or skin lesion.
Which Patients Can Benefit From SCS?
- Patients with chronic, severe, and repeated pain,
- Patients with chronic pain who cannot benefit from traditional treatment methods,
- The patient should have had a psychiatric evaluation,
- The patient should not be addicted to any drug.
Conditions Treated By SCS:
- Neuropathic pain related with the nervous system that cannot be cured by pain killers
- Neuropathic pain in diabetic patients
- Pain seen in unsuccessful lumbar surgery syndrome
- Phantom pain due to organ amputation
- Obstructive vascular diseases
- Chest pain that became chronic after coronary heart surgery
- Buerger and Raynaud disease
- Pain occurring in active bladder diseases
- Urinary and faecal incontinence (discharge of urea or faeces)
- Pelvic pain
In recent years, this treatment method has been preferred in eliminating chest pain that occurs due to heart diseases (dorsal cord stimulation angina pectoris).
Moreover, SCS can be used in the treatment of occipital nerve neuralgia and peripheral nerve neuropathies.
Recently, the application of this technique for sacral stimulation is becoming more common in the treatment of urea and faeces discharge, pelvic pain, and pain related with interstitial cystitis.