A spinal cord stimulator is a surgically implanted device used to treat chronic pain, such as back pain. The device transmits low-level electrical signals to block pain signals from reaching the brain. Spinal cord stimulator surgery may be an option for people with chronic pain when other treatment options have failed.
Chronic pain affects quality of life. According to the National Center for Complementary and Integrative Health1, about 8.2% of adults in the United States have severe chronic back pain. About 75% of those with severe pain report difficulties with work and social participation, self-care, and mobility. Spinal cord stimulation surgery can lead to a marked decrease in pain and improvement in overall well-being.
The guide below examines the success rate of a spinal cord stimulator, predictors of a successful outcome, and how to prepare for the procedure.
What is the Success Rate of a Spinal Cord Stimulator?
The success of a spinal cord stimulator is measured by whether it improves long-term pain. However, the perception of pain is subjective. This means no specific blood test, imaging study, or exam measures pain.
Pain’s subjectivity influences any statistics on the procedure's success. As such, the success rates of spinal stimulators vary depending on the study. In general, the long-term success rate of a cord stimulator ranges from 47% to 74%.
Spinal cord stimulation does not eliminate the cause or source of pain. For example, if you have pain from a spinal cord injury, the cord stimulator does not repair the cord. Instead, spinal cord stimulation changes how your brain perceives or interprets pain signals. Because of this, the degree of pain relief a person receives varies and is self-reported by the patient.
Advances in Spinal Cord Stimulators and Success Rates
Spinal cord stimulation devices have improved in recent years. While past studies may have included older-generation devices, spinal cord device technology2 has been enhanced over the past decade. The devices often have customized neurostimulative therapy, which helps improve patient-specific treatment. These improvements may have a positive effect on success rates in future studies.
Causes of Pain that Spinal Stimulation May Successfully Treat
Spinal cord stimulation may provide pain relief for a variety of conditions that lead to chronic pain. During your consultation for the procedure, your doctor will evaluate the cause of the pain and determine if spinal cord stimulation may be an option. In most cases, spinal stimulation is recommended after other forms of treatment have not treated pain effectively. Some of these conditions spinal stimulation may help include:
- Failed back surgery syndrome
- Nerve-related pain
- Complex regional pain syndrome
- Injuries to the spinal cord
Predictive Factors for Spinal Cord Stimulator Success Rate
There are a few factors that increase the success rate of spinal cord stimulators. During your consultation, your doctor will review your medical history, back pain symptoms, and medications. Based on these factors, your doctor may determine if you are a good candidate for a successful procedure.
Wait time Before Spinal Cord Stimulation
Having chronic pain for many years may decrease the chances of spinal cord stimulation's success. Studies have shown that a spinal cord implant is up to 75% effective3 when performed within two years of the onset of long-term pain. More recent research indicates even higher success rates of 85%4 with spinal cord stimulation within two years from the start of ongoing pain.
Smoking
Smoking cigarettes also may affect whether the stimulator is successful. Research shows5 that smoking may adversely affect the success of the procedure for several reasons. For example, nicotine in cigarettes may affect how someone perceives painful stimuli, increasing neuropathic pain.
Additionally, tobacco may slow down wound healing, which can affect recovery. The physiological effects are complex but may include alternations in myofibroblast function. Myofibroblasts are cells that play a role in tissue repair and wound healing. Smoking may decrease peripheral tissue blood flow, which also stunts healing.
Willingness to Activity Engage in Ongoing Device Care
After spinal cord stimulation, a willingness to follow ongoing device care is helpful. Device care may include regular follow-up appointments, device programming updates, and wireless recharging.
How Can Someone Prepare for a Spinal Cord Stimulation?
Following your doctor's recommendations for preparing for a spinal cord stimulator may impact surgery and improve the success of the procedure. Adhering to postoperative instructions may also decrease complications of spinal cord stimulators.
Preoperative instructions may include not taking certain medications a few days before your procedure. Your doctor may also recommend you quit smoking. You will be given specific instructions before your procedure that will be most relevant to your circumstances.
Postoperative directions may also promote a successful outcome after surgery. Instructions after surgery may include caring for the incision site and activity restriction.
Is Spinal Cord Stimulation Surgery Successful in Eliminating Pain in All Cases?
Before having a spinal cord stimulation device, it is common to wonder if the stimulator works in all cases. Even after a successful spinal cord stimulator trial, it is possible the device will not eliminate all pain. It is important to remember that not all treatments work for everyone.
However, as the studies noted above indicate, spinal cord stimulation can significantly reduce pain for many people. By minimizing pain, spinal cord stimulation surgery can positively affect someone's ability to work and enjoy time with friends and family. This can be life-changing for someone living with long-term pain.
Summary
The success of a spinal cord stimulator in treating pain, such as complex regional pain syndrome, may depend on several factors, such as the cause and duration of the pain. However, spinal cord stimulation surgery is more likely to provide pain relief when the stimulator is placed within the first two years of the onset of pain. It may be an option when other treatments, such as physical therapy, have not helped.
If you have any questions about spinal cord stimulation, we are happy to help. If you would like to schedule a consultation, please contact us today!
References
- U.S. National Survey Identifies Associations Between Chronic Severe Back Pain and Disability. (2022). National Center for Complementary And Integrative Health. https://www.nccih.nih.gov/research/research-results/us-national-survey-identifies-associations-between-chronic-severe-back-pain-and-disability
- Rauck, R. L., Loudermilk, E., Thomson, S. J., Paz-Solis, J. F., Bojrab, L., Noles, J., ... & Jain, R. (2023). Long-term safety of spinal cord stimulation systems in a prospective, global registry of patients with chronic pain. Pain management, 13(2), 115-127. https://www.tandfonline.com/doi/full/10.2217/pmt-2022-0091
- American Academy of Pain Medicine (AAPM). (2014, March 6). Reducing wait times could improve spinal cord stimulator success for chronic pain. ScienceDaily. https://www.sciencedaily.com/releases/2014/03/140306211027.htm
- Dydyk AM, Tadi P. Spinal Cord Stimulator Implant. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK555994/
- De La Cruz P, Fama C, Roth S, Haller J, Wilock M, Lange S, Pilitsis J. Predictors of Spinal Cord Stimulation Success. Neuromodulation. 2015 Oct;18(7):599-602; discussion 602. doi: 10.1111/ner.12325. Epub 2015 Jun 28. PMID: 26119040; PMCID: PMC4615463. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615463/
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