Another Implant for the Radiologists-Spinal Cord Stimulator

An adult lady with  history of breathing difficulty  Chest X ray essentially is unremarkable other than  presence spinal cord stimulator (SCS).
By Dr MGK Murthy & Dr Sumer Sethi

What is SCS?

Also called dorsal column stimulator, is  device placed subcutaneously  to the  epidural location  to pass low voltage  current to better  manage pain

Components?

It has usually 4-16 electrodes, lead wire  that extends to pulse generator usually place under  the buttocks

How does  it work?

 When turned on with remote control(on req basis), it  stimulates the nerves in  dorsal cord to produce  tingling in the region of pain. The electric current  interferes with the passage of pain message to the brain. SCS does not eliminate the cause of the pain,it interrupts the pain signal from reaching  the brain. The goal of SCS is to reduce the pain signal by 50 -70 %.

Uses?  Indications?

Commonly resorted to when other pain management techniques have failed 

Useful in failed back surgery (40%of spinal surgeries may result in this ), any other refractory pain including ischaemic limb ,etc

 Future?

Being  tried in migraines and parkinsonism

Radiologists Role?

Suggest lead displacement/complications including infections, aspirations, lead migrations etc. MRI  is likely to be contraindicated and can produce  malfunction of the device