Permanent implantation is done as a minimally invasive outpatient procedure.
If the trial procedure has been successful, a permanent implantation is scheduled to be performed at a later date. The trial leads are always removed at the trial’s conclusion. A trial is considered successful when it results in pain relief of at least 50% accompanied by an improvement in function. During a three- to ten-day trial period, patients receive stimulation through these thin, temporary lead wires which are connected to an external trialing cable and an external test stimulator. With the trial procedure, a patient receives an external test stimulator in a simple outpatient procedure where temporary leads are placed via a needle using flouroscopy for guidance. If the trial does not live up to expectations, the trial wires can be removed in a simple office procedure with almost no discomfort and without damaging the spinal cord and nerves. As a result, before a spinal cord stimulator is permanently implanted, a trial stimulation is always performed first. Some find the neurostimulation sensation to be uncomfortable, and for others, the treatment doesn’t fully address their areas of pain. Spinal cord stimulation does not work for everyone.
The trial lead wires are secured to the skin with a small suture and the system is covered with a large bandage or dressing on the back during the trial period.
This helps guide the doctor in placement of the leads.
During the procedure the patient may receive IV sedation to relax but is awake so when the device is activated the patient can provide feedback and tell the doctor whether pain is relieved. During a spinal cord stimulator trial, lead wires with stimulating electrodes are placed through a hollow needle that is inserted through the skin of the low back, under x-ray guidance, into the epidural space or spinal canal. When it is decided that spinal cord stimulation may benefit a patient the first step is a “trial” which can be performed in the outpatient setting. When activated, the device sends impulses that block pain messages to the brain.
A Spinal Cord Simulator is an implantable device that consists of a tiny insulated wire called a lead, and a power source called a battery or receiver. Spinal Cord Stimulator, also called dorsal column neurostimulation, is a treatment that may be indicated for some types of chronic pain conditions.