Spinal Cord Stimulation

Spinal cord stimulation (SCS) is an interventional pain management technique in which an implanted device delivers low-level electrical impulses to the spinal cord, modulating pain signal transmission and providing relief for patients with chronic neuropathic pain conditions that have failed conservative and pharmacological treatment. SilverOak Health's pain management team offers the full range of modern SCS modalities — including conventional tonic stimulation, high-frequency (10 kHz) stimulation, burst stimulation, and dorsal root ganglion stimulation — selecting the optimal technology for each patient's pain pattern.

Indications for SCS include failed back surgery syndrome (persistent or recurrent leg and back pain after spinal surgery), complex regional pain syndrome (CRPS), painful diabetic neuropathy, refractory angina, and peripheral vascular disease pain. The procedure is performed in two stages: a trial phase of five to seven days in which temporary leads are placed in the epidural space under fluoroscopic guidance and the patient assesses pain relief at home, followed by permanent implantation in responders with confirmed ≥50% pain reduction.

Permanent SCS implantation involves placement of paddle or percutaneous leads at the target spinal cord level, connected to a rechargeable or primary cell implantable pulse generator. Post-implantation programming optimises stimulation parameters using dedicated software to achieve maximal pain coverage. Modern closed-loop SCS systems with automatic feedback adjustment maintain consistent stimulation despite postural changes, addressing a major limitation of earlier fixed-output devices. Long-term outcomes demonstrate durable 50–70% pain reduction in responders, significant reduction in opioid requirements, and meaningful improvements in function and quality of life.