SCS Therapy: The Complete Guide
Next Steps
If You Have Not Had Surgery (Type 1: No Clear Surgical Target / Type 2: Large-Scale Fusion Required)
| Step | What to do |
|---|---|
| 1 | Talk to your primary care doctor -- "I have been told that surgery is difficult (or that a large fusion is needed). I would like to learn about SCS as a treatment option." |
| 2 | Get a referral to a pain clinic or SCS specialist -- A referral from your spine surgeon is preferred |
| 3 | Specialist consultation -- Reassessment of imaging and symptoms, determination of SCS candidacy, comparison with surgery (including weighing the risks of multi-level fusion against the benefits of SCS) |
| 4 | Trial period (approximately 1 week) -- Confirm the effect, adjust stimulation settings |
| 5 | Decision -- If effective, proceed to permanent implantation / If not effective, explore other options |
Advice for patients who have not had surgery:
Think of SCS not as "the option because surgery is impossible," but as "an effective treatment option for neuropathic pain." If multi-level fusion is needed, the risk of post-surgical complications (adjacent segment disease, infection, etc.) increases with each additional level, making a careful comparison with SCS particularly important. The best window for considering SCS is 6 months to 2 years after conservative treatment.
If You Have Had Surgery (Type 3: Pain Persists After Surgery)
| Step | What to do |
|---|---|
| 1 | Talk to your spine surgeon -- "My pain has continued after surgery, and I would like to learn about SCS." |
| 2 | Check whether reoperation is possible -- Confirm with imaging whether compression remains and whether reoperation would be effective |
| 3 | Get a referral to a pain clinic or SCS specialist -- A referral from your spine surgeon is ideal |
| 4 | Specialist consultation -- Assessment of candidacy for post-surgical spinal pain syndrome, explanation of the trial |
| 5 | Trial period (approximately 1 week) -- Confirm the effect, adjust stimulation settings |
| 6 | Decision -- If effective (60-80%), proceed to permanent implantation / If not effective, explore other pain management approaches |
Advice for patients who have had surgery:
Post-surgical pain (post-surgical spinal pain syndrome) is one of the best indications for SCS. With a success rate of 60 to 80%, many patients experience significant pain relief. If your pain continues 3 to 6 months after surgery, we recommend considering SCS sooner rather than later.