A recent report published in the Journal of Neurosurgery: Spine reviewed 20 years worth of data investigating the safety and effectiveness of spinal cord simulation (SCS) for the treatment of chronic pain. This treatment sends electrical pulses into the spinal cord to cause paraesthesia in painful body parts. The author of the report found that although there is only a limited amount of good research available, evidence tends to suggest that SCS has positive, long-term symptomatic benefits for patients with chronic pain disorders of various causes.
A report published in a 2004 issue of the Journal of Neurosurgery: Spine pooled together results from numerous studies conducted from 1981 looking at the long-term risks and benefits of spinal cord simulation (SCS) treatment for chronic pain disorders. This method of treatment was first introduced in 1967 and since then has been widely used in the management of various pain disorders such as chronic back pain. Doctors are not entirely sure how SCS works but know that it sends electrical pulses to the posterior part of the spinal cord that has some involvement in sensing pain. Electrodes and leads can carry the signal through the skin or sometimes part of the vertebra needs to be removed so the leads can reach the spinal column more directly. Various devices are connected outside the body to power the device.
The current report looked at 68 studies with 3679 patients, focussing on the effectiveness of the treatment. The author also specifically considered the safety of SCS wfhich was evaluated in 51 studies, corresponding to a total population of 2972. The author gathered all the appropriate results and found that overall SCS causes long-term improvements in pain levels in patients with angina pain, severe ischemic (reduced vascular supply) limb pain and chronic lower back pain. SCS may therefore be considered an effective treatment if you suffer pain from one of these disorders. It has not been evaluated in the treatment of pain secondary to cancer.
Research also found that SCS was a relatively safe treatment. Most patients in the studies had only minor complications that could easily be treated by removing the device. The most common complication was migration of the leads out of the correct spot which reduced pain relief and needed repeat surgery to fix. More serious complications were only found in very small numbers of patients such as paralysis, infection, allergic reactions and skin damage. Some patients also get headaches, dizziness and twitches. If you are considering this treatment your doctor will discuss all the potential risks with you in more detail. Overall however, SCS is considered safe and has fewer side effects compared to other alternate treatments such as opioid pain relief medications.
The results of this report are quite promising but the studies on SCS treatment so far have not been ideal. Many of them were on small samples of patients and didn’t include a baseline comparison to ensure the treatment is actually working. Doctors will therefore await further research to conclude the benefits of this treatment. However, so far SCS has shown to be a safe and effective treatment for chronic pain disorders that may be used more frequently in the future. This may help large numbers of patients in the community that suffer severe pain of the back and limbs on a daily basis. Of course not everyone is suitable for this treatment so you should see your doctor to discuss all your options for pain relief. Your doctor will decide what is best for you based on your underlying condition and medical history.