Spinal cord stimulation (SCS), an advanced treatment offered by the Division of Algology at Ondokuz Mayıs University (OMU) Faculty of Medicine, is providing a new treatment option for patients whose quality of life has been severely affected by chronic pain and who have not benefited sufficiently from other therapies.

The treatment, sometimes popularly described in Türkiye as a “pain-relief implant,” costs approximately USD 10,000 and is covered by the public healthcare system for patients who meet the required criteria.

It is particularly used for persistent pain following unsuccessful spinal surgery, including operations for lumbar and cervical disc disorders, as well as for selected patients with other forms of chronic pain.

At OMU, spinal cord stimulation is considered an advanced option for patients who have not achieved adequate relief from medication or interventional pain-management procedures. For suitable patients, the treatment can significantly reduce long-standing severe pain and help them return to everyday activities.

The procedure is funded by the Social Security Institution (SGK) for patients who meet the established eligibility requirements.

“Spinal Cord Stimulation Interrupts Pain Signals Travelling to the Brain”

Algology specialist Prof. Dr. Fatih Özkan explained that the treatment works by modifying the transmission of pain signals through the spinal cord.

“As algologists, we work with people experiencing chronic pain,” Prof. Dr. Özkan said. “Chronic pain is generally described as pain lasting more than three months, although that does not mean a patient needs to wait for three months before it can be addressed as a chronic problem. If we expect the pain to persist, we can approach it accordingly.”

He noted that some chronic pain conditions may continue despite all available conventional treatments.

“In such cases, when appropriate, we use spinal cord stimulation, and we can see substantial benefits,” he said.

Prof. Dr. Özkan explained that the system is designed to interfere with pain signals before they reach the brain.

“The basic principle is to prevent the pain signal from reaching the brain, regardless of the underlying condition causing the pain. This can be achieved at the level of the spinal cord,” he said. “Very thin electrodes are placed in this area, and controlled electrical impulses at different frequencies are used to modify the transmission of pain signals. In this way, we reduce the brain’s perception of pain and can relieve the patient’s symptoms.”

He said spinal cord stimulation is commonly used in patients who continue to experience severe pain following spinal surgery, particularly patients who have undergone surgery for lumbar disc problems without obtaining sufficient relief.

Prof. Dr. Özkan also emphasized that the devices are publicly funded, although patients must undergo a detailed assessment process before receiving a permanent implant.

“These are very expensive treatments, and there are several stages that must be completed before we can use them,” he said. “Relevant medical departments must also agree that implantation of the system is necessary for the patient.”

Treatment Costs Around USD 10,000 and Is Publicly Funded for Eligible Patients

Algology specialist Assoc. Prof. Dr. Mustafa Kurçaloğlu described spinal cord stimulation as a highly advanced treatment reserved for chronic pain that does not respond adequately to standard approaches.

“Spinal cord stimulation is one of the final treatment options we use for chronic pain and pain that has not responded to standard therapies,” Assoc. Prof. Dr. Kurçaloğlu said. “It is technically demanding and requires considerable experience and commitment from the physician.”

He added that the treatment is also costly.

“A spinal cord stimulator currently costs the public healthcare system around USD 10,000 per patient,” he said. “For that reason, patient selection is extremely important. We need to offer the treatment to patients who are genuinely likely to benefit from it.”

Before recommending spinal cord stimulation, the OMU team carefully evaluates each patient’s clinical condition.

“We first use treatments such as pain-relieving medication, epidural injections, radiofrequency procedures, and other interventional algology techniques,” Kurçaloğlu explained. “If the patient still has severe pain that significantly affects daily life after these approaches, we then consider spinal cord stimulation.”

Trial Period Comes Before Permanent Implantation

According to Assoc. Prof. Dr. Kurçaloğlu, approximately 70 percent of the patients receiving spinal cord stimulators at OMU have previously undergone surgery for lumbar disc disorders.

“We use this system in patients who have undergone surgery for a lumbar disc problem but continue to experience pain, particularly when it has been concluded that another operation would not provide further benefit,” he said.

Spinal cord stimulation may also be considered for selected patients who continue to experience pain following cervical disc surgery.

Kurçaloğlu emphasized that Türkiye’s public reimbursement system makes the treatment accessible to eligible patients, while regulatory safeguards are intended to ensure that it is used appropriately.

“There are rules established by the Ministry of Health and the Social Security Institution to prevent misuse and ensure that the treatment is provided to suitable patients,” he said.

When spinal cord stimulation is being considered, patients must first be evaluated by specialists in psychiatry, neurosurgery, and physical medicine and rehabilitation.

If other approaches have failed to provide adequate relief, the patient then undergoes a trial period.

“We first place electrodes in the epidural space around the spinal cord and send the patient home with a temporary stimulator,” Kurçaloğlu explained. “The patient continues normal daily life for several weeks. To proceed to permanent implantation, the patient must report at least a 50 percent improvement with the temporary system.”

If the trial is successful, the patient returns for implantation of the permanent device.

“My Pain Subsided and I Began Walking Again”

One patient treated with spinal cord stimulation, Cengiz Kaymak, described years of persistent pain following a spinal cord injury caused by an accident.

“I suffered a spinal cord injury after an accident, and the pain never went away,” Kaymak said. “I underwent six operations over six years, but my pain continued. Spinal cord stimulation was then recommended.”

Kaymak said he had also been unable to walk before receiving the implant.

“After the stimulator was implanted, my pain subsided and I began walking again,” he said.

He later experienced problems caused by damaged electrodes and returned to the pain clinic for further treatment.

“When the device malfunctioned, my pain increased dramatically,” he said. “After receiving treatment again, I was able to return to my normal life.”

“I Felt the Benefit During the 15-Day Trial”

Another patient, Mehmet Ceylan, said physicians recommended spinal cord stimulation because of pain associated with pancreatic insufficiency.

“I accepted the recommendation without hesitation,” Ceylan said. “We had a 15-day trial period, and I experienced benefits during that time.”

Following the successful trial, he received the permanent system.

“Assoc. Prof. Dr. Mustafa Kurçaloğlu provided all the support I needed. The permanent device was then implanted, and I am very satisfied with the outcome,” he said.