HF Spinal Cord Stimulation

Boston PainCare uses High-Frequency Spinal Cord Stimulation for patients suffering from a range of pain conditions. Spinal cord stimulation (SCS) reduces pain by changing the way pain signals are sent to the brain by delivering electrical energy to the spinal column. In addition to pain relief, SCS treatment can improve a patient’s ability to carry out everyday activities and also reduce the need for medication treatments that often cause unpleasant side effects.

Who is a candidate for high frequency SCS treatment?

SCS treatment is considered appropriate for patients suffering from moderate to severe chronic pain and for whom other more conservative treatment are ineffective. While many conditions may benefit from the use of SCS treatment, some of the most common include:

Chronic Back Pain
Failed Back Surgery
Post Laminectomy Syndrome (cervical or lumbar)
Arachnoiditis (painful inflammation and scarring of meninges of the spinal nerves)
Complex Regional Pain Syndrome (CRPS)
Peripheral Neuropathy
Phantom Limb Pain

Potential candidates at Boston PainCare undergo a comprehensive evaluation with the clinic’s pain specialists in order to provide education about SCS treatment, answer any questions or concerns, and to make sure SCS is the best treatment option. Depression and anxiety are often experienced by pain patients and can reduce the effectiveness of pain treatments. In order to ensure each candidate for SCS treatment has the best opportunity for success, behavioral heath assessments are also provided during the evaluation process for each candidate.

SCS Trial

While the use of high frequency SCS treatment is highly successful in most patients, unfortunately not all will experience benefit. As such, a 7-day trial of stimulation therapy is performed before considering permanent implant of the device. During the trial, 2 small catheter leads are inserted through a needle into the space around the spinal cord. An x-ray machine is used to help guide the pain physician specialist in placing the leads into the correct level of the spine. Local anesthesia is used during the procedure to ensure patient comfort, and the option to receive sedation is also available. Once placed, the leads are secured with tape to the back and the patient is then taken to the recovery area. Patients receive education from the device manufacturer representative on the use of the device prior to discharge, and the representative is in daily contact during the trial with the patient to provide guidance with the treatment programming. After a week or so the patient returns to meet with their pain specialist to discuss whether or not there has been any pain relief and improved functioning during the trial timeframe. If so, then the patient can move on to a permanent placement of the stimulator.

Permanent Implant

Permanent implantation of the device is offered to patients who experience improved functioning and at least 50% pain relief during the trial. Permanent implantation involves surgically placing a small generator device under the skin which is attached to 2 new leads that are again inserted into the space around the spinal cord. This procedure is performed as an outpatient procedure and typically occurs 4-6 weeks after the completion of the SCS trial.

Post Implantation

Following implantation, patients are followed by a Boston PainCare pain specialist every 3-6 months for a period of two years to monitor the patient progress and success with the SCS device. During this time patients are provided with ongoing education regarding the use of SCS treatment, are encouraged to increase their overall activity level, and assisted in the reduction or elimination of their medical treatments.

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