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Why Choose Spinal Cord Stimulation (SCS)?

Spinal Cord Stimulation NYC New York City Manhattan

Spinal Cord Stimulation (SCS) is a particularly appealing option for those with chronic who are hoping to avoid surgery. The field of Neuromodulation (aka neuroaugmentation, aka neurostimulation) was born from the need to find an alternative to surgery. SCS adheres to the fundamental principles of Minimally Invasive Surgery (MIS) by avoiding the excessive tissue injury and scarring inherent to open surgery. The important thing to remember is a SCS trial is not surgery, in fact there is no cutting of any kind. Patients get to test out the neurostimulation in a fully reversible fashion to see if it works and is effective in treating their specific pain complaints.
Everyone’s pain is different and no two person’s complaints are the same. This may explain why spinal surgery is successful in some (61%)[1] yet in others their pain is made worse – the approach and treatment of the procedure itself is virtually identical, regardless of any nuances in their pain complaints. SCS is truly customizable to each person’s particular complaints, no matter how subtle the variation.
When compared to conventional open surgery as a treatment for neck or low back pain, SCS has considerable advantages:

Spinal Cord Stimulator TrialOpen Spinal Surgery
Outpatient procedure and can be performed right in the your doctor’s office
Performed in the hospital
Depending on your insurance, may require as little as an office visit copayCan be very expensive when considering co-insurance likely due to the physician, anesthesiologist and the hospital
Takes less than an hour, start-to-finishTakes several hours with considerable post-operative pain
Virtually no recovery timeLong recovery time
Go back to work the next dayMay be weeks before returning to work
No post-operative rehab or physical therapy during the trialSeveral months of physical therapy
Can be performed under local anestheticPerformed under general anesthesia and requires intubation
Low risk profileHigh risk profile
ReversibleIrreversible and considerable chance pain could get worse
Is Spinal Cord Stimulation similar to TENS?
The only similarity between SCS and TENS is that both use electrical signals to control pain (Gate Control Theory). TENS is vastly inferior to Spinal Cord Stimulation due to a number of limitations.
Spinal Cord StimulationTENS
Under the skinOutside the skin
Signal transmitted directly at the level of the spinal cord and not dependent on tissue depthWeaker signal and gets weaker traveling through the skin and all the underlying tissue
No regular maintenance except for rechargingRequires constant maintenance; needs to be put on and taken off daily
Battery replaced once every 10 years approximately*Pads need to be constantly reordered which can be costly
Once implanted, nothing is external – everything is located under the skinBulky external device
Can control pain in multiple areas at once without needing the leads to be movedCannot treat sciatica - can only control pain the area where the pads are located
Can be constantly changed and customized (even after implantation) through a wireless signal between the device and an external, handheld programming remote without ever having to remote the SCSLimited customization
*depends on type or battery and level of usage
[1] Turner JA, Herron J, Hasselkorn J, et al. Patient outcomes after spine fusion. JAMA 1992;268:907-911.

Dr. Corey Hunter is a nationally recognized interventional pain physician and the founder of Ainsworth Insitute. His publications have appeared in textbooks on treating pain and he is a regular contributor in leading pain management journals.