Spinal Cord Stimulator Trial

The SCS generates an electric field to modify nerve conduction of pain signals to the brain. Some SCS devices use a low- frequency current to replace the pain sensation with a mild tingling feeling called paresthesia. Other SCS devices use high-frequency or burst pulses to mask the pain with no tingling feeling. Stimulation does not work for everyone. Some patients may find the sensation unpleasant. In other cases it may not cover the entire pain area. For these reasons a TRIAL STIMULATION is performed before the device is permanently implanted.

Patients with chronic and severe neuropathic pain, who have not responded to other more conservative treatments. Neuropathic pain is pain due to damaged nerve tissue. Common examples include patients with lower back pain from failed back surgery, leg or arm pain also referred to as radiculopathy, diabetic neuropathy, and reflex sympathetic dystrophy.

The procedure is safe, however with any procedure there are risks, side effects and possibility of complications. Common side effects are bruising and soreness. Less common risks are short term weakness or numbness, headache, bleeding or infections.

Once it is determined you are a candidate for a SCS and you are interested in moving forward with a trial, we will request authorization from your insurance company. Not all insurances will cover the procedure.

Prior to the trial, you will have a psychological evaluation to help determine if you are a good candidate for spinal cord stimulation. Insurance companies require this before you can have the trial.

Some patients can decide right away if this therapy works for them and others may need more time to decide.

If you are on blood thinners or take any medications that may affect you blood’s ability to clot, you will be given specific instructions on when to hold these medications.

If you experience significant pain relief during the trial, and you and your doctor agree that the trial was a success, you can proceed with long-term therapy.

Usually the patient who has had a trial has a very good idea if it was a success. Typically, the physician is looking for a significant increase in activity tolerance or a significant decrease in the need for pain medication or some combination of both. The trial is considered successful if you received 50 to 70% relief of your pain.

The procedure takes place at a surgery center. To ensure proper placement of the wires you may be mildly sedated. You will be conscious although some patients may not remember parts of the procedure.

You must bring the prescribed antibiotics with you the day of the procedure.

The trial uses a temporary spinal cord stimulator system. The external generator is connected to insulated thin wires that are placed into the epidural space of your spine to delver the electrical impulses. The trial period is typically 7 to 10 days. This gives you an opportunity to experience spinal cord stimulation and evaluate the benefit without having to undergo a full implantation.

If your pain is involving the low back and legs the electrodes are inserted in the midline (along the spine) of the lower back, usually above any previous surgery. If your pain is involving the arms, the electrodes are inserted in the midline of the upper back. Once the wires are in position the doctor will connect them to a small external generator that will be worn outside the body. You will be taken to the recovery room, where further programing of the external generator will take place.

Prior to releasing you home, the staff will review your discharge instructions. You will be discharged home with these instructions.

• Take your antibiotics as prescribed.
• Have a responsible adult stay with you for at least 24 hours .
• You may experience some drowsiness, light headedness or mild nausea. Stand and move with caution if you do have light headedness.
• Resume usual activities the following day; especially those activities that cause familiar pain.
• Use caution when changing positions. Move without twisting by moving your shoulder and hip at the same time.
• DO NOT drive, or operate equipment for 24 hours.
• DO NOT drive with the system on.
• DO NOT reach, bend, stretch, twist or lift more than 5 lbs.
• DO NOT disconnect the trial cable from the leads.
• Resume your normal diet.

During the evalutation period you will be asked to keep a diary. You may be asked:

• To log the number of hours you used it.
• What setting worked the best or was used the most?
• Did you sleep better?
• Were you able to perform activities that you couldn’t perform before?
• Were you able to decrease your pain medications?

• DO NOT REMOVE THE DRESSING. Keep the dressing clean and dry. You may reinforce the dressing with medical tape if it comes loose.
• DO NOT SHOWER OR TUB BATH. You may sponge bathe.
• DO NOT pull on or become entangled in the cable.

• The trial leads pull out.
• Fever of 101 or higher.
• Excessive bleeding, redness, swelling, or foul odor at the surgical site.
• An increase in pain at the surgical site.