A guide to the spinal cord stimulator trial period
Spinal cord stimulator procedures are unique in that they typically involve a trial period. The goal of this trial is to determine if spinal cord stimulation will be an effective form of treatment before the device is permanently placed. If there is a successful trial, patients can then move forward for the full procedure.
Patients looking into spinal cord stimulator procedures who want to learn more about what is involved in the trial period should take a moment to read the following practical guide. Spinal cord stimulator therapy can be a highly effective way to relieve chronic pain for a number of specific conditions and a better understanding of what makes a successful trial can help you determine if it is right for you.
Who is a potential candidate for spinal cord stimulator trials?
Spinal cord stimulation therapy works by sending a gentle electrical pulse near the spinal cord to disrupt chronic pain signals that travel from spinal nerves to the brain. Stimulators consist of a generator pack connected to two small thin wires that attach to electrodes that can be placed on tissue. In the case of spinal stimulation, surgeons will attach the electrodes to the epidural space immediately around the spinal cord.
In a permanent procedure, the generator pack is implanted discreetly in the body, usually either in the lower back or the abdomen. However, before implanting the device permanently, surgeons will typically administer a trial to see if electrical stimulation can offer relief.
Spinal cord stimulator candidates are typically chronic pain sufferers who have fully exhausted conservative treatments for their condition or illness without finding the relief necessary to perform daily activities. In many cases, patients have also previously undergone a spine surgery that resulted in complications or insufficient pain relief.
Spinal cord stimulation can help patients dealing with the following conditions:
- Chronic pain related to a spine condition such as bulging or herniated discs
- Failed back surgery syndrome (FBSS)
- Arachnoiditis, which is inflammation of a spinal membrane
- Complex regional pain syndrome
- Diabetic neuropathy
- Angina or other cardiovascular complications
What to expect during the trial period
The FDA strongly recommends any patient undergo the trial period to ensure satisfactory pain relief. For the spinal cord stimulator trial procedure, the surgeon will access the target area of the spine to attach the electrodes, or leads. This can often be accomplished by injecting a very thin hollow needle and guiding it with the help of X-ray technology. During this procedure, the surgeon and patient can communicate to ensure that all pain areas are covered
The wires are then connected to an external generator that sends the electrical impulses to the spinal nerves. The patient is then given a handheld controller that is programmed based on patient feedback. The surgeon or member of the treatment team will then explain how to adjust the controller to alter the amount of electrical stimulation traveling to the spinal nerves.
The whole procedure lasts no more than one to two hours and requires minimal recovery. Patients can return home on the same day of the procedure.
How long does the trial period last?
Spinal cord stimulator trials typically last about a week, or five to seven days on average. During this time, patients can practice adjusting the controller and noting how it offers relief. The surgeon or another treatment professional will typically ask the patient to notate pain relief levels, particularly during different times of day and activities.
How do doctors and patients determine a successful trial?
After the trial period, the patient will consult with the surgeon again to determine whether or not the stimulator offered significant relief during daily activities to warrant a permanent procedure. The expectation for a successful trial is increased comfort throughout the day and night and a higher aptitude for carrying out daily activities.
What to expect during the permanent spinal cord stimulator procedure
The permanent spinal cord stimulator procedure is similar to the trial procedure in many ways. In some cases, the trial leads can remain on the spinal cord but in other situations they may need replacement depending on the specific device and procedure. The primary difference with a permanent procedure is that the surgeon will need to make a small incision to implant the generator pack as well as carefully tunnel the wires.
This procedure is still minimally invasive and can be performed on an outpatient basis. Recovery is limited compared to many other spine conditions, but it is still important to follow instructions and not resume activities too quickly to ensure the device is set properly while the body heals.
It is also common for patients to instruct family members or close friends on how to adjust or turn off the controller if the patient is unable to for any reason.
Learn more about spinal cord stimulation with USA Spine Care
At our state-of-the-art outpatient centers, our experienced and skilled surgical team has decades of combined experience performing spinal cord stimulator trials, as well as determining whether there was a successful trial and performing permanent procedures. We’re committed to exceptional care and patient education, all with a streamlined experience that ensures everyone who comes to us for relief feels involved and confident at every step of their journey.
If you’d like to learn more about how we can help you get back to a healthy and active lifestyle, contact us today.
Call toll free 1-866-249-1627.