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, 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, and many patients experience significant pain relief. Ask your doctor what degree of improvement you can realistically expect in your case. If your pain continues 3 to 6 months after surgery, we recommend considering SCS sooner rather than later.