You’ve been struggling with chronic back or neck pain, and perhaps it’s radiating into your limbs, and you just want relief. Whether you’ve tried other treatments without success, or you just don’t like the idea of medications, you’ve decided to try spinal cord stimulation.
Each year in the United States, 50,000 spinal cord stimulators are implanted, and each of these recipients goes through a trial period beforehand. In the following, the team here at Genesis Orthopaedic and Spine discusses why we perform a trial for spinal cord stimulation (SCS) and what you can expect.
The simple answer to this question is: to be sure the treatment works to relieve your symptoms. In fact, the FDA released a letter to health care providers that outlined the importance of a trial period, stating, “Permanent SCS should only be implanted in patients who have undergone and passed a stimulation trial.”
Passing a stimulation trial means you achieve at least a 50% reduction in your pain symptoms. Only when this threshold is met do we then move on to a permanent implant of your spinal cord stimulator.
With a spinal cord stimulator, we implant electrodes into the area along your spine where we believe the nerves are overactive. These electrodes emit electrical impulses that are designed to disrupt the pain messaging to your brain.
The primary difference between a permanent implantation of your SCS and a trial period is that we don’t implant the generator for these electrodes. During your trial period, you’ll wear a portable generator on a belt around your waist, as opposed to having us implant the generator under your skin.
When you undergo a trial period for your SCS, you first come to our offices so we can outfit you with the temporary device.
First, we apply a local anesthetic and then, using live X-ray guidance, we guide the leads into position. To ensure that they’re in the right area, we send mild electrical currents through the electrodes, and you communicate with us as to whether you’re feeling any effect (usually a tingling sensation).
Once we’re satisfied that the electrodes cover the nerves that are causing you problems, we attach them to an external generator and you’re free to go home to start your trial period.
During this trial period, you control the generator and the strength of the electrical currents, within preestablished ranges. Rest assured, we make sure that you fully understand how to use the device before you leave our office.
In most cases, a trial period lasts 5-7 days, and we want you to use this time wisely to determine whether the SCS is providing you with meaningful relief.
At the end of your trial period, you return to us and, if the treatment was successful, we can arrange for permanent implantation of your SCS. If you failed to find relief during your trial period, we will move on to other treatment options.
If you have more questions about your spinal cord stimulation trial period, please don't hesitate to contact one of our offices in West Orange or Westfield, New Jersey.