- What is spinal cord stimulation?
Spinal cord stimulation is a safe and effective therapy for managing certain types of chronic pain. When you have pain, spinal cord stimulation disrupts the signals traveling between the spinal cord and the brain so that you may feel pain relief.
- What are the benefits of spinal cord stimulation?
- Improved ability to function and participate in the activities of daily living
- Effective pain relief
- Possible reduction or elimination of oral pain medications
- Controllable- you can manage your own therapy
- Why is a trial performed?
A trial is important for a variety of reasons. It serves as a temporary evaluation period so you and your doctor can decide if spinal cord stimulation works for you before committing to a long term therapy. It allows you to:
- Assess how well the neurostimulator relieves pain during your daily activities.
- Decide if you want to have the implant.
- Understand how the system components work and feel the varied levels of stimulation that the system can provide.
- What can I expect prior to the trial?
The physician will review your past medical history, your diagnostic studies and previous therapies before suggesting a spinal cord stimulation trial. In most cases, your insurance company will require you to have a psychological evaluation to help determine if you are a good candidate for spinal cord stimulation. After all the information is gathered and insurance approval is obtained, you will be scheduled for the trial.
- How do I prepare for the trial?
- You should shower or bathe the night before the trial or the morning of the trial as you will not be allowed to get the dressing wet after the procedure until the trial is completed.
- You may have nothing to eat or drink after midnight.
- You may take your routine medications with a small sip of water on the morning of the trial.
- You will need to have someone drive you to and from the facility on the day of the trial.
- How is the procedure performed?
- An IV will started to give you an antibiotic to prevent an infection and also to allow the staff to give you sedation during the procedure.
- You will positioned on your tummy on the OR table.
- Your back will be cleaned with an antiseptic solution and a local anesthetic injected
- A special needle will be inserted into the epidural space using X-ray guidance. Temporary medical wires (leads) will be inserted via the needle into the epidural space.
- The leads are connected to a screening cable and the external neurostimulator.
- The doctor will ask you questions about the stimulation you are feeling, as well as where it is located to be sure the leads are in the best location for you.
- The temporary leads will be sutured in place and a dressing will be placed to help secure the leads.
- You will be taken to the Recovery Area,
- What happens after the leads are placed?
In the Recovery Area, the representative will work with you and your doctor to program the external neurostimulator to provide you with the best possible relief.
You will be taught:
- How to use the handheld programmer.
- How to care for the area around the leads.
- What activities to avoid during the trial.
You might experience some discomfort in the area of your back where the leads are placed. This is temporary and will resolve in the hours after the procedure. You may also experience some changes in the intensity of the stimulation with certain activities during the trial.
- How long will the trial last?
The trial lasts 3-7 days, depending on your doctor’s preference.
- Are there risks during the trial?
Complications can occur during the trial including bleeding into the epidural space, infection and other side effects. You should not undergo the trial if you have an active infection at the time of the trial.
- What will happen after the trial period ends?
When you return to the office, the lead wires will be removed and a Band-Aid applied. You will discuss your experience during the trial with your doctor and be asked if you were satisfied with the pain relief you experienced. Together with the doctor, you will decide if you should proceed with the implantation of a permanent stimulator. If you decide that you would like to have the neurostimulator permanently implanted, you will be referred to a surgeon for the procedure.