Spinal Cord Stimulation Trial
Procedure Description:
A spinal cord stimulation (SCS) trial is used to evaluate the effectiveness of SCS to treat pain before proceeding with SCS implant surgery. SCS delivers a sophisticated electrical signal to the spinal cord that has potential to substantially reduce chronic pain. Some signals can be felt as a light “buzzing” sensation but most are invisible and work without being felt. The trial typically lasts 3-7 days. Typically two wires called “leads”, the thickness of angel hair pasta, are inserted into the spine using needles (no incisions). The needles are removed and the leads are taped to the lower back.
What it treats:
SCS has the potential to substantially improve pain in the neck, upper and lower backs, head, shoulders, arms/hands, chest, abdomen, hip, buttocks, groin, and legs/feet. SCS most effectively treats chronic nerve pain associated with the spine, shingles, nerve injury, CRPS, and neuropathy, in particular diabetic neuropathy.
How it is performed:
A SCS trial is performed using a special X-Ray machine called a fluoroscope. This allows the provider to position the leads quickly and effectively. The procedure typically takes less than 30 minutes. The provider numbs the area before the procedure to minimize discomfort. The procedure can be performed with or without IV sedation.
Pre-procedure instructions:
The procedure is usually performed with IV sedation so do not eat or drink for 8 hours prior to the procedure and do not drive for 12 hours after the procedure. A driver home is required and must be a friend or family member. If no IV sedation, then can be a ride service such as Uber. Medications that prevent blood clotting (aspirin, coumadin, Plavix, Eliquis, Xarelto, etc), will need to be held prior to, during, and after the SCS trial with the prescribing physician’s permission. Make sure to inform your provider if you are on any blood thinners so additional instructions can be provided. An oral antibiotic is typically prescribed prior to the trial. Fill this before and have it ready to start after the trial.
What to expect after the procedure:
After the procedure, there may be mild procedure related soreness. During the duration of the trial, avoid excessive bending or twisting as this may cause the leads to shift out of place. The dressings affixing the lead to the skin must stay dry so no showers or baths, sponge bath only. Take the oral antibiotics as instructed. Avoid strenuous activity that may cause sweating as this can loosen the dressings. The SCS manufacturer representative stays in close contact to monitor progress and adjust settings. At the conclusion of the trial, the physician removes the leads which is a quick, simple, and usually painless process.