Spinal cord stimulator Trial

 You may have had a stubborn pain which has not responded to other forms of treatments. On the other hand, you really do not want to go through surgery or you already had surgery which was a failure (yes, this happens). Now we have a big blessing! This is spinal cord stimulator.

The cool thing about it is that you may test it for a few days to see if it works for you or not.

The main part of spinal cord stimulator is the lead. It is a thin, flexible wire that delivers electrical impulses to the spinal cord to help control chronic pain. It is a smart device, like a minicomputer. It has also its own charger within this thin wire!

How Successful Is Spinal Cord Stimulation (SCS)?

The FDA says spinal cord stimulators are one of the top three devices for reported problems. Most people do well with spinal cord stimulation. About 75% of patients have a successful trial and go on to get the full implant. After one year, around 65% of patients still have good results, meaning they feel at least 50% less pain.

About 60% of people still had at least 50% pain relief after two years. 

Even many years later, patients are still happy. About 80% of people were satisfied with their results 10 years after getting the implant.

Key Steps in the Trial Phase of Spinal Cord Stimulation:

1. Pre-Procedure Evaluation

• Before starting the trial, your doctor conducts a thorough evaluation and confirms that more conservative treatments (such as medications or physical therapy) have not provided sufficient relief.

2. Trial Procedure

• Insertion of Temporary Leads: During the trial, temporary leads are inserted into the epidural space of the spine, which is the space around the spinal cord. This is done under fluoroscopic guidance (live X-ray imaging) to ensure proper placement of the leads near the nerves responsible for the pain. You can watch a video about this procedure here. Epidural space is the most favorite destination for a pain doctor. It is also closest to spinal nerves for a doctor. Imagine going to an aquarium with a shark tank. You can stand behind the glasses and see the sharks within a short distance. The glass is dura. The water is CSF, and the shark is the spinal cord. Where you stand is epidural space. It is safe!
• After the procedure: A professional lead technician will change some settings in this smart lead. See him or her as an electrician.  Now let’s see your pain signal pacing leisurely in spinal cord will be intersected by an electrical signal close by.
• The leads are connected to an external pulse generator (rather than an implanted one) that the patient wears on a belt or clothing during the trial period. This external generator delivers the electrical impulses that modulate pain signals.

3. Trial Period (Typically 3-7 Days)

• Monitoring and Adjustment: Over the course of several days, you use the temporary spinal cord stimulator in your daily routine to assess the level of pain relief. If there is no change, another setting in this minicomputer can be tried. Not all clothes fit you!

4. Assessment of Trial Results

• At the end of the trial period, you return to the clinic for an evaluation and at the same time pulling these leads. By this time, you and your doctor would know if you pass this test and are ready to go to the next level. If the trial is successful and you are happy from its help, you will have the permanent implantation of the spinal cord stimulator. The lead removal is very easy. It is done in the office and is not painful. It is basically just pulling it out! Done in 5 seconds.