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	~~'''~~Spinal Cord Stimulator~~'''~~		== Spinal Cord Stimulator ==

	~~A '''spinal cord stimulator''' (SCS) is a medical device used to exert pulsed electrical signals to the~~ [[spinal cord]] to control chronic pain. Spinal cord stimulators consist of stimulating electrodes, an electrical pulse generator, a programmable remote control, and a battery. The device is surgically implanted under the skin and works by interrupting pain signals before they reach the brain.		[[File:Anterior_thoracic_SCS.jpg\|thumb\|right\|An anterior thoracic spinal cord stimulator implant.]]

	~~==Indications==~~		A '''spinal cord stimulator''' (SCS) is a medical device used to manage chronic pain by sending electrical impulses to the [[spinal cord]]. These impulses interfere with the nerve signals that communicate pain to the brain, providing relief for patients with conditions such as [[failed back surgery syndrome]], [[complex regional pain syndrome]], and other neuropathic pain disorders.
	~~Spinal~~ cord ~~stimulation~~ is ~~most commonly recommended for patients who suffer from~~ chronic pain~~, especially in~~ the ~~back, arms, and legs, and have not found relief from other treatments. Conditions that may benefit from SCS include:~~
	* [[~~Chronic Pain\|Chronic neuropathic pain~~]]
	* [[Complex Regional Pain Syndrome\|Complex regional pain ~~syndrome (CRPS)]]~~
	* [[~~Failed Back Surgery Syndrome\|Failed~~ back surgery syndrome ~~(FBSS)~~]]
	* [[~~Ischemic Pain\|Ischemic~~ pain]] ~~from peripheral vascular disease or refractory angina~~

	==~~Mechanism of Action~~==		== History ==
	The exact mechanism by which spinal cord stimulation works is not fully understood, but it is believed to involve the direct inhibition of pain signal transmission in the spinal cord and the modulation of pain processing in the brain. This is often described by the gate control theory of pain.

	~~==Procedure==~~		The concept of using electrical stimulation for pain relief dates back to ancient times, but the modern spinal cord stimulator was first developed in the 1960s. The first implantable SCS was introduced in 1967, and since then, the technology has evolved significantly, with advancements in [[neurostimulation]] techniques and device miniaturization.
	The ~~implantation~~ of a spinal cord stimulator ~~involves two main stages:~~ the ~~trial~~ and the ~~permanent implantation. During the trial period~~, ~~temporary electrodes are placed~~ in ~~the epidural space of the spinal cord. If the patient experiences significant pain relief, a permanent system may be implanted~~.

	===~~Trial Phase~~===		== Components ==
	The trial phase is a critical step in determining the effectiveness of spinal cord stimulation for the patient. It typically lasts about a week, during which the patient can assess the level of pain relief and any improvements in daily activities.

	==~~=Permanent Implantation=~~==		A spinal cord stimulator system typically consists of three main components:
	If the trial ~~phase~~ is successful, ~~the~~ permanent ~~implantation~~ is ~~scheduled~~. ~~This involves placing~~ the ~~electrodes~~ in the ~~epidural space and~~ the ~~pulse generator under~~ the ~~skin~~, ~~usually in~~ the ~~buttock~~ or ~~abdomen~~.
			* '''Electrodes''': These are placed in the epidural space near the spinal cord. They deliver electrical impulses to the targeted nerves.
			* '''Pulse generator''': This is a small device implanted under the skin, usually in the abdomen or buttocks, which generates the electrical impulses.
			* '''Remote control''': Patients use this to adjust the intensity and pattern of the stimulation according to their needs.

			== Procedure ==

			The implantation of a spinal cord stimulator is usually performed in two stages:

			1. '''Trial phase''': Temporary electrodes are placed to determine if the patient experiences significant pain relief.
			2. '''Permanent implantation''': If the trial is successful, a permanent system is implanted.

			The procedure is minimally invasive and typically performed under local anesthesia with sedation.

			== Mechanism of Action ==

			The spinal cord stimulator works by delivering electrical impulses that modify the transmission of pain signals in the [[dorsal column]] of the spinal cord. This process is known as "[[gate control theory]]" of pain, where the electrical stimulation "closes the gate" to pain signals, preventing them from reaching the brain.

			== Indications ==

			Spinal cord stimulators are indicated for patients with chronic pain conditions that have not responded to conservative treatments such as medication, physical therapy, or surgery. Common indications include:

			* [[Failed back surgery syndrome]]
			* [[Complex regional pain syndrome]]
			* [[Peripheral neuropathy]]
			* [[Ischemic pain]]

			== Risks and Complications ==

			While generally safe, spinal cord stimulator implantation carries some risks, including:

	~~==Risks and Complications==~~
	~~As with any surgical procedure, there are risks associated with the implantation of a spinal cord stimulator. These may include:~~
	* Infection		* Infection
	* Bleeding		* Bleeding
	* ~~Lead migration~~		* Nerve damage
	* Device malfunction		* Device malfunction
	* Pain at the implant site

	~~==Outcomes==~~		Patients may also experience changes in stimulation over time, requiring adjustments to the device settings.
	~~Many patients~~ experience ~~significant pain relief from spinal cord~~ stimulation, ~~allowing them~~ to ~~decrease or eliminate their use of pain medications and improve their quality of life. However, outcomes vary, and it is important for patients to have realistic expectations~~.
			== Related Pages ==

	~~==Future Directions==~~		* [[Neurostimulation]]
	Advancements in spinal cord stimulation technology continue to evolve, with research focusing on improving the efficacy, reducing side effects, and expanding the indications for use. This includes the development of devices that can record and respond to neural signals in real time, offering a more personalized approach to pain management.		* [[Chronic pain management]]
			* [[Pain management]]
			* [[Neuropathic pain]]

	~~[[Category:~~Medical ~~Devices]]~~		{{Medical devices}}
	~~[[Category:Pain Management]]~~
	~~[[Category:Neurotechnology]]~~

	~~{{Medicine-stub}}~~		[[Category:Medical devices]]
			[[Category:Pain management]]

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'''Spinal Cord Stimulator'''

A '''spinal cord stimulator''' (SCS) is a medical device used to exert pulsed electrical signals to the [[spinal cord]] to control chronic pain. Spinal cord stimulators consist of stimulating electrodes, an electrical pulse generator, a programmable remote control, and a battery. The device is surgically implanted under the skin and works by interrupting pain signals before they reach the brain.

==Indications==
Spinal cord stimulation is most commonly recommended for patients who suffer from chronic pain, especially in the back, arms, and legs, and have not found relief from other treatments. Conditions that may benefit from SCS include:
* [[Chronic Pain|Chronic neuropathic pain]]
* [[Complex Regional Pain Syndrome|Complex regional pain syndrome (CRPS)]]
* [[Failed Back Surgery Syndrome|Failed back surgery syndrome (FBSS)]]
* [[Ischemic Pain|Ischemic pain]] from peripheral vascular disease or refractory angina

==Mechanism of Action==
The exact mechanism by which spinal cord stimulation works is not fully understood, but it is believed to involve the direct inhibition of pain signal transmission in the spinal cord and the modulation of pain processing in the brain. This is often described by the gate control theory of pain.

==Procedure==
The implantation of a spinal cord stimulator involves two main stages: the trial and the permanent implantation. During the trial period, temporary electrodes are placed in the epidural space of the spinal cord. If the patient experiences significant pain relief, a permanent system may be implanted.

===Trial Phase===
The trial phase is a critical step in determining the effectiveness of spinal cord stimulation for the patient. It typically lasts about a week, during which the patient can assess the level of pain relief and any improvements in daily activities.

===Permanent Implantation===
If the trial phase is successful, the permanent implantation is scheduled. This involves placing the electrodes in the epidural space and the pulse generator under the skin, usually in the buttock or abdomen.

==Risks and Complications==
As with any surgical procedure, there are risks associated with the implantation of a spinal cord stimulator. These may include:
* Infection
* Bleeding
* Lead migration
* Device malfunction
* Pain at the implant site

==Outcomes==
Many patients experience significant pain relief from spinal cord stimulation, allowing them to decrease or eliminate their use of pain medications and improve their quality of life. However, outcomes vary, and it is important for patients to have realistic expectations.

==Future Directions==
Advancements in spinal cord stimulation technology continue to evolve, with research focusing on improving the efficacy, reducing side effects, and expanding the indications for use. This includes the development of devices that can record and respond to neural signals in real time, offering a more personalized approach to pain management.

[[Category:Medical Devices]]
[[Category:Pain Management]]
[[Category:Neurotechnology]]

{{Medicine-stub}}

Spinal cord stimulator - Revision history

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