What is a Spinal Cord Stimulator (SCS) Trial?
A spinal cord stimulator (SCS) implant trial is a preliminary, temporary procedure used to evaluate whether a patient is a suitable candidate for permanent spinal cord stimulation therapy. The trial allows the patient and physician to determine if the SCS system can effectively provide relief for the patient’s chronic, neuropathic pain in the back, arms, and legs.
How is a Spinal Cord Stimulator (SCS) Trial Performed?
The SCS implant trial procedure involves the following steps:
- 1. Anesthesia: The injection site on the back is numbed with a local anesthetic to minimize discomfort.
- 2. Lead Placement: One or more thin, insulated wire leads are carefully inserted through an epidural needle or a small incision into the space surrounding the spinal cord, called the epidural space.
- 3. Nerve Stimulation: Electrodes at the end of the leads produce electrical pulses that stimulate the surrounding nerves. This electrical stimulation is intended to block the transmission of pain signals to the brain.
- 4. Patient Feedback: The patient provides real-time feedback to the physician to help determine the optimal placement of the leads in order to best target and alleviate the patient’s specific pain pattern.
- 5. External Stimulator Connection: The leads are then connected to an external trial stimulator. The patient will use this external device for approximately one week to further evaluate the effectiveness of the spinal cord stimulation.
What Supplies and Medications are Used for a Spinal Cord Stimulator (SCS) Trial?
The key components for a spinal cord stimulator trial include:
- – Local anesthetic (e.g. lidocaine) to numb the injection/incision site
- – Spinal cord stimulator leads with electrodes
- – External trial stimulator device
- – Fluoroscopic imaging equipment to guide lead placement
The physician selects the appropriate SCS system components and techniques based on the patient’s individual anatomy and pain condition.
What to Expect after a Spinal Cord Stimulator (SCS) Trial?
After the procedure and during the trial period, patients can turn the external stimulator on and off and adjust the intensity of the electrical pulses within certain parameters. They will monitor and report any changes in their pain levels to their physician.
If the patient and physician determine that the SCS trial provided an acceptable level of pain relief, the next step may be to proceed with a permanent SCS implantation. At the end of the trial period, the temporary leads are simply removed at a follow up office visit within a few days of the trial procedure.
Patients should follow all instructions provided by their healthcare team regarding activity restrictions, wound care, and any necessary follow-up visits during the trial period. Promptly reporting any concerns, such as increased pain or signs of infection, is also important.