About Your Spinal Cord Stimulator (SCS)

This information explains your spinal cord stimulator (SCS), including how it works and how it’s placed.

About Your SCS

An SCS is a small, round device that’s used to treat pain. It’s implanted (surgically placed) under your skin in your abdomen (belly) or upper buttocks and your upper spine. The SCS works by sending electrical signals to the nerves around your spine. The electrical signals block your nerves from feeling pain.

SCSs are usually used to treat:

• Lower back pain, especially after surgery.
• Arm, chest, abdomen, or leg pain.
• Pain after shingles, including pain in your face.
• Severe nerve pain that doesn’t get better with other treatments.

If you have a pacemaker, bleeding problems (such as a low platelet count), or are taking a blood thinner (medication that affects the way your blood clots), an SCS may not be the right treatment for you. If you have a curved spine, placing an SCS may be hard. Talk with your doctor to see if an SCS would help with your pain.

The parts of your SCS

The SCS has 3 main parts: the battery, the leads, and a wireless remote (see Figure 1).

• The battery is the round part of the device. It’s about the size of a matchbook and weighs about 2 ounces. The battery is implanted into your abdomen or upper buttocks.
• The leads are the wires coming out of the battery. You will have 1 or 2 leads. These are implanted in your upper spine.
• The remote is a handheld device that comes with your SCS. You can adjust the settings of your SCS using the remote. Your doctor will give you more information about how and when to adjust your settings.

The battery sends the electrical signals through the leads to your nerves to block them from feeling pain.

SCS Screening Test

Before getting an SCS, you will first have a screening test to see if it will help with your pain. For your screening test, you will have a lead implanted into your spine. The other end of the lead will be attached to a temporary SCS battery that will be taped to the skin above your waist. You will also get a remote to adjust the settings of your SCS. After your temporary SCS is placed, you will leave the hospital with it.

You will wear the temporary SCS for about 7 to 10 days. Then, you will have a follow-up appointment with your doctor to remove your temporary SCS and talk about if a permanent SCS will help you manage your pain.

Your doctor will give you more information about your SCS screening test, including what to expect and how to get ready for it.

About Your SCS Placement

If you and your doctor decide that this is the right treatment for you, you will have surgery to implant your SCS. Your nurse will give you more information about your surgery and tell you how to get ready.

You will have to wait about 10 days after your temporary SCS is removed to have your surgery. This will give your body time to heal after having your temporary SCS removed.

Most insurance companies, including Medicare, cover the cost of the SCS screening test and placement. Call your insurance company to see if you will be covered.

Your insurance company may also want you to have psychological testing done before approving the permanent SCS. Call your insurance company for more information.

What to expect during your surgery

You will get anesthesia (medication to make you sleep) before your surgery starts. Once you’re asleep, your doctor will make a small incision (surgical cut) in your abdomen or upper buttocks to place the battery. The battery will look like a small bulge under your skin.

Your doctor will use fluoroscopy (a type of x-ray) to find the exact area to place the leads. Once the area is found, your doctor will place the leads around your spine using 2 small needles. They will then connect the leads to the battery. Your incision will be closed with staples or sutures (stitches).

Your surgery will take 1 to 3 hours.

After your surgery, you will be taken to the recovery room. In the recovery room, your doctor will begin programming your SCS to give you pain relief based on how much pain you’re feeling and where your pain is. Instead of pain, you may feel tingling. Your nurse will teach you how to adjust the strength and settings of your SCS using the remote. 

You will have your SCS in place for as long as you need it to help you manage your pain.

‌  Your SCS may set off metal detectors. You will get a card that says you have an implanted device. You must carry this card with you while you have your SCS in place, both in the hospital and at home. You will get this card in the hospital or it will be sent to you a few weeks after your surgery.

What to expect after your surgery

After your surgery, your incisions may be sore. You will be given a prescription for pain medication before you leave the hospital. Talk with your doctor or nurse about possible side effects and when you should start switching to over-the-counter pain medications (medications you buy without a prescription).

For 6 weeks after your surgery, follow these guidelines so your body can heal.

• Don’t lift anything heavier than 10 pounds (4.5 kilograms).
• Don’t bend over, such as to pick something up from the ground.
• Don’t twist your body, such as to crack your back.
• Don’t put your body in extreme hot or cold temperatures, such as in a sauna, hot tub, or ice bath.

Follow-up appointments

You will have a follow-up appointment with your doctor 1 to 2 weeks after your surgery. Your doctor will take out your sutures during this appointment.

You will have a follow-up appointment with your pain doctor 1 to 2 months after your surgery to see if your SCS is helping you with your pain.

You will also have follow-up appointments every 1 to 3 months to adjust the settings of your SCS to better treat your pain.

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