How Does Electrical Spinal Cord Stimulation Work?
Electrical spinal cord stimulation (ESCS) involves the delivery of a low-voltage electrical current to the dorsal structures of the spinal cord to reduce pain. The treating physician, typically an interventional pain specialist, would insert an electrode/lead in the cervical, thoracic or lumbar epidural space. This is connected to a stimulator box (pulse generator), which is subcutaneously implanted into the abdominal wall.3 Placement of the leads is based on the patient’s description of the paresthesia. When the symptomatology is primarily in the lower extremities, the treating physician places the leads over the thoracic segments of the spinal cord.5 The patient has the ability to switch the stimulation on and off, and adjust the intensity of the pulses via the stimulator box. There are two types of leads: percutaneous round leads and neurosurgical flat leads. The majority of stimulator trials use the percutaneous leads since the implantation process is less invasive. The treating ph
