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Monday, May 19, 2014

What is Spinal Cord Stimulation (SCS)? Shown and Explained with Color X-Ray and Color MRI Images

Spinal Cord Stimulation (SCS) also called "Dorsal Column Stimulation" delivers electrical impulses to the Spinal Cord and Spinal Nerves to disrupt pain signals from reaching our Brain.
The History of this principle of using electricity as a form of "pain treatment" goes back to ancient times when eels were used to deliver their electrical discharges to patient suffering from pain.
This principle was rediscovered in the 1965 when researchers developed the something called the "Gate Control Theory". This theory in simple terms suggests that delivering electrical impulses to the Nerves carrying sensation within the Spinal Cord could subsequently "shut off" the Nerves carrying pain signals. Initially, Spinal Cord Stimulation Devices were implanted directly into the Spinal Cord, however this was deemed too dangerous due to the potential to injury the Spinal Cord in the process. Today, the Spinal Cord Stimulation "Lead" which delivers the electrical impulses to the Spinal Cord is implanted into the "Epidural Space", a space outside of the Spinal Cord.

Let's first review some of the Anatomy of the Spine to understand where and how Spinal Cord Stimulators (SCS) are implanted.

This Spine Image is a Color MRI (Magnetic Resonance Image) produced by Medical Media Images. The whole body Color MRI on the left is designed to orient you in the human body. The main Image on the right is a cut-out of the Lumbar Spine (low back). The main structures of the Lumbar Spine Anatomy are shown:
1. The Spinal Cord in yellow. It actually ends in the upper part of our low back, however a bundle of Spinal Nerves (cauda equina) continues downward.  2. The body of the Vertebra. This is the largest part of the Vertebra. 3. The Spinal Disc which is our natural "cushion" or "shock-absorber" between the Vertebrae. 4. The Spinal Fluid shown in light blue bathes the Spinal Cord and Spinal Nerves providing protection and nutrition. 5. The Epidural Space shown in pink. Notice how this space is located behind the Spinal Cord and Spinal Nerves. It is separated from them by a thin layer of Spinal Fluid. This is the space where the Spinal Cord Stimulation Electrodes are implanted.

Color MRI Lumbar Spine Anatomy
Color MRI Image of the Lumbar Spine Anatomy

The following Spine Image shows you the Spine in cross-section to give you a better 3-Dimensional impression of the location of this epidural Space as well as Spine Anatomy. Notice how the small white box the whole body Color MRI (Magnetic Resonance Imaging) on the left shows you where the large Image on the right is taken from. The Epidural Space is again shown in pink. Other parts of the surrounding Spine Anatomy are shown.

Color MRI Lumbar Spine Anatomy
Color MRI Image of the Lumbar Spine Anatomy in cross-section

The next Spine Image is a Color X-Ray Image which shows you the different components of the Spinal Cord Stimulation System. The typical System consists of: 1. An Electrical Generator which is battery powered and implanted under the skin. This Generator produces preset types and patterns of Electrical Impulses. Its computer chips are highly programmable to change many different parameters such as the strength of each impulse, duration, location, etc. A handheld programmer can "talk" to the Generator to turn it on/off and adjusts its programs. 2. A Spinal Cord Stimulation Lead (Electrode) which is implanted in the Epidural Space and delivers the electrical impulses to the Spinal Cord. 3. Connecting Wires which connect the Generator to the Lead.

Color X-Ray Spinal Cord Stimulation
Color X-Ray Image of a Spinal Cord Stimulation System

The Image below is an Interactive version of the above Image. Just move your mouse cursor over the Image and see text appear by each Interactive Tag. 

Color X-Ray Lumbar Spinal Cord Stimulation
Interactive Color X-Ray of a Lumbar Spinal Cord Stimulator
Spinal Cord Stimulation technology is primarily used to control severe pain conditions, however has also shown usefulness to help with angina, reduced blood flow conditions (e.g. diabetic foot issues), and even most recently paralysis. When used to control severe pain, typically a "trial" of  the technology is undertaken to see if it is effective and tolerated.

The use of Spinal Cord Stimulation to help paralyzed patients regain some motor control (initiate movement) is potentially one of the most exciting applications of this technology. A recent Study in the Journal "Brain" showed some success using Spinal Cord Stimulation for Spinal Cord Injury patients.

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Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

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