Spinal Cord Stimulation: FAQs

What outcome can FBSS patients expect with SCS?

Most achieve significant reduction in neuropathic pain (especially leg pain) and improvement in quality of life measures. However, some data show diminishing effectiveness after two years.

Will SCS completely eliminate pain?

SCS is unlikely to make patients pain-free, but it may reduce pain intensity enough to improve function and reduce medication use.

How soon after surgery can someone consider SCS?

SCS is indicated only after a period of persistent pain (>12 weeks) and failure of non-surgical treatments; timing may vary by insurer and physician judgment.

What risks or complications are associated with SCS?

Possibilities include infection, lead migration, hardware failure, local pain, or rarely neurologic injury. Most complications are minor or manageable

Is SCS reversible?

Yes, electrodes and generators can be removed if therapy is ineffective or complications arise.

Can SCS interfere with other medical devices or procedures?

It may affect MRI safety and will need special consideration or conditional MRI-compatible devices.

How is pain relief measured during SCS trials?

Relief is subjectively measured; most insurers require >50% or >70% pain reduction for permanent implant eligibility.

Does SCS work better for leg pain or back pain?

Most studies show SCS works best for radiating leg pain rather than axial back pain, but some patients benefit for both.

Can SCS improve function or return to work?

Yes, improved function, decreased disability, better sleep, and increased activity levels are reported, with some returning to work or daily activities.

What kind of follow-up is needed after SCS?

Regular device checks, programming adjustments, and pain management visits are required to optimize stimulation.

Yes, SCS can complement reduced medication regimens but may not eliminate them.

Psychological screening is mandatory; untreated depression, anxiety, or substance abuse decrease likelihood of success.

Coverage is widespread, but requirements vary; criteria must be met for Medicare and private insurers.

Active infection, coagulopathy, severe psychiatric disorder, or inability to operate device are contraindications.

Generators typically last 5-10 years before battery replacement; lead longevity is variable.

SCS is not curative; it is considered palliative, managing symptoms to improve quality of life.

Lack of response, technical issues (lead migration, hardware failure), or progression of underlying disease may limit success.

Yes, programming is customizable for different pain patterns, activities, or sleep states.

Yes, devices and programming vary, with differences in battery life, stimulation options, and MRI compatibility.

Consultation with a board-certified pain specialist, spine surgeon, or neurosurgeon, and review of insurance guidelines, is recommended.

What is Failed Back Surgical Syndrome (FBSS)?

FBSS refers to persistent or worsening pain after spinal surgery, unrelated to poor surgical technique but due to unresolved, recurrent, or new spinal pathology.

What symptoms do FBSS patients commonly experience?

Patients may have chronic back pain (>12 weeks), nerve pain (sciatica), leg pain, numbness, tingling, headaches, or restricted mobility.

What is spinal cord stimulation (SCS)?

SCS is a minimally invasive therapy using implanted electrodes to send mild electrical pulses to the spinal cord, disrupting pain signals before they reach the brain.

How does SCS help relieve pain for FBSS patients?

SCS modulates or blocks nerve signals responsible for chronic pain, altering brain perception to reduce intensity or sensation of pain.

Are there criteria for insurance approval for SCS?

Candidates generally suffer from chronic, refractory pain unresponsive to medications, physical therapy, injections, and have a clear diagnosis of neuropathic pain.

What is the typical process for SCS implantation?

Yes. Insurers typically require proof of failed conservative treatments, psychological evaluation, significant pain reduction during trial stimulation, and documentation by a multidisciplinary team

What happens during the SCS trial period?

Temporary electrodes are placed via a minimally invasive procedure, connected to an external device the patient wears, testing symptom relief.

How is the permanent SCS device implanted?

If the trial is successful (>50-70% pain relief), permanent leads and a small generator are implanted under the skin, typically under local or general anesthesia.

What types of SCS devices and stimulation technologies exist?

Devices vary by pulse waveform (traditional tonic, burst, high-frequency, and closed-loop feedback), and by manufacturer.

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^{This summary is suitable for patient education, clinical reference, or insurance review regarding spinal cord stimulator use in failed back surgery syndrome.}