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Spinal Cord Stimulators (SCS) Device Selection & New Technology

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Do you treat and manage patients suffering chronic pain? New advances in the technology of spinal cord stimulators have recently been introduced allowing clinicians to choose the most appropriate device for each patient from a broad range of neurostimulation systems.

"No two patients experience the same pain – or experience it in the same way " (Dr Timothy Deer MD – Centre for Pain Relief, Charleston, WV, USA)

Choosing the right device for the right patient is most important. There are three different types of SCS systems available, they are all similar in that an implantable pulse generator (IPG) and a lead (s) are implanted, but where they differ is in the power source and what is required from the patient for a successful outcome.

 The rapidly expanding field of spinal cord stimulation devices now has a number of options available.

  • Radio-frequency (RF) System – has a generator with an external power source which must be worn when stimulation is required.
  • Conventional IPG System – the power source is in the generator, requires the least amount of effort on the part of the patient but needs to be surgically replaced when the power runs out.
  • Rechargeable IPG System – the most recent innovation, is similar to the conventional system however, the power lasts longer as the power source can be recharged. The patient is responsible for recharging the power source when it is low.

There is available a wide choice of leads for varying pain patterns and indications. Each electrode on each lead (up to 16 electrodes) can be programmed as an array or individually, controlling amplitude, pulse width and frequency.

The range of patients treated with spinal cord stimulation is wide under the approved indication of chronic intractable pain and includes phantom limb pain, complex regional pain syndrome (CRPS) , types of neuropathy and persistent post – surgical back pain. Developing areas of research include intractable angina, urinary incontinence, neuralgia and interstitial cystitis.

The panel of speakers includes:


  • Claudio Feler MD, Associate Professor of Neurosurgery, University of Tennessee.
  • Timothy Deer MD, Director, The Center for Pain Relief, Charleston, West Virginia.
  • Robert Levy MD, Professor of Neurologic Surgery, Feinberg School of Medicine, Northwestern University, Chicago.

The video emphasises that safety and appropriate device selection are of high importance for successful outcomes.

Discussion includes:

  • Those best suited to Conventional IPG vs RF vs Rechargeable Systems.
  • Those not suited to Rechargeable Systems.
  • The choice when high-amplitude or multiple programmes are required.
  • The health, motivation and intellectual capacity of the patient to operate the device.
  • Local factors, such as extreme obesity, skin thickness, and sensitive skin that may affect choice.
ANS forum on pain management device selection
Video (12 MB)

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Dates

Posted On: 18 May, 2007
Modified On: 19 March, 2014

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