How Does A Spinal Cord Stimulator Trial Work?

Prior to receiving a final spinal cord stimulator implant, the patient needs to receive a spinal cord stimulator trial. The trial can tell the physician if the patient will potentially do well with the final implant. The typical rule of thumb is if the patient receives 50% or greater pain relief with the SCS trial, then the final implant is indicated.

The SCS trial is done in as an outpatient by a physician trained in such procedures. The patient receives IV sedation but cannot be knocked out fully as the physician needs input from the patient during the procedure. The patient is placed face down on a procedure table that allows x-rays to go through it (radiolucent). The procedure is performed with a fluoroscope (real time x-ray machine).

The skin and soft tissues down to the spine are numbed fully and then a guide needle is placed through the anesthetized track. Through the guide needle, the spinal cord stimulator trial catheter is fed and goes into the epidural space, which is the area around the spinal cord. The fluoroscopy machine helps guide the catheter placement, as the catheter contains a visible piece of metal on it.

Once the catheter is placed in the initial position deemed acceptable, the representative from the spinal cord stimulator company being used passes a sterile power attachment into the operating field and the physician then turns it on and initial programming of the electrical stimulation is performed.

The patient now becomes an active participant in the procedure. Sedated but not out, the patient will then respond where he or she feels the electrical sensation. The catheter is manipulated by the physician and placed so that the patient feels the electrical sensation where the pain is typically felt on a daily basis. This could be leg pain, back pain, or both.

Once the placement obtaining optimal electrical coverage is achieved, the catheter is stitched to the skin where it comes out and multiple bandages are placed to keep the area sterile. The SCS trial is then left in place for the next 3-5 days as an outpatient with the catheter receiving electrical impulses to see how it works. The catheter is attached to a battery pack/program unit which attaches to the patient's waist.

On a follow up visit to the physician's office, the catheter is removed in the office with a wound check. The patient then relays how much pain relief was achieved and the decision is made whether or not to proceed for a final spinal cord stimulator implant.