A Case for Spinal Cord Stimulation Therapy— Don't Delay Spinal cord stimulation should no longer be considered the treatment of "last resort." Long-term success rates reach 85% if SCS is performed within 2 years of symptom onset.

and minimally invasive implantation technique. Moreover, its effects are completely reversible. SCS involves placement of one or more lead(s), consist-ing of a longitudinal array of contacts (electrodes), into the dorsal epidural space using either a percutaneous technique or through a small laminotomy. The leads are powered by a battery (implantable pulse generator [IPG]), which delivers pulsed electrical energy. This electrical stimulation produces analgesia by inhibiting nociceptive transmission. A multi-tude of lead types with varying number of contact points and spacing are now available, enabling precise targeting of the area of pain, while avoiding undesirable stimulation. The flexibility of the device is further augmented by improved programming capabilities, which allow adjust-ment of stimulation parameters such as pulse-width, fre-quency, anode/cathode contact configuration, and ampli-tude. These parameters are optimized by a neuromodulator and can be further modified by the patient within a specified range through a hand-held programmer. The Food and Drug Administration (FDA) has approved SCS for treatment of chronic, intractable trunk and limb