Spinal Cord Stimulation Trial Instructions
Spinal cord stimulation is used to relieve neuropathic pain (pain caused by damaged nerves) in people who have failed conservative treatment such as medications or injections and are not a candidate for surgery. It uses electrical impulses to change transmission of pain signals from the spinal cord to the brain.
There are two steps involved in the process. First is a trial which consists of placing and electrical lead on the spinal cord. This is done in the OR or clinic. You will go home the same day. The lead is connected to a battery generator which is outside your body. You will be given instructions on how to use this control device before you go home. You will be able to turn the stimulations on and off, and increase the intensity. You will have the temporary system for one week. This will allow you time to use the stimulator and ensure that it is effective.
How do I prepare for the procedure?
- You MUST have a driver
- You may have clear liquids after midnight until 2 hours before your appointment and then nothing to eat or drink. Clear liquids include Jell-O, broth, 7-Up, tea, coffee and apple juice. No milk or milk products.
- Bring a list of your medications including does and how often you take them.
- The staff in I & O surgery or the clinic will call you the afternoon or evening before your procedure to let you know what time to arrive. They will review your instructions including what medication you may take.
What happens during the procedure?
- After arriving in I & O surgery or the clinic, you will be taken to the pre-op area where an intravenous access will be started.
- You will be taken to the OR room or procedure room. You will be positioned on your stomach.
- Relaxing medicine will be given but you are not a sleep.
- The doctor must talk to you during the procedure. The device will be turned on and you will be asked where you are feeling the stimulation. The location of the lead will be adjusted until it covers the painful areas.
- After the lead is in the proper place and the appropriate strength of the stimulation is achieved you will be taken to the recovery room or to the I & O surgery.
- When fully recovered you will allowed to go home.
What complications might occur?
The complications of this procedure include the following but are not limited to:
- Severe headache
- Bleeding/epidural hematoma
- Lead migration
- Injury to the spinal cord/nerve damage/paralysis
- Take it easy until the next day.
- Lumbar support or cervical collar will be provided.
- Do Not drive with the stimulator on.
- Do not raise your arms above your head.
- Do not twist or bend.
- Report any signs of infection, fever, or problems with the stimulator.
- Sponge baths only – no showers or tub baths.
You will return to the clinic in one week to have the trial stimulator lead removed. The doctor will then discuss your response to the stimulation and determine whether to proceed to the 2nd step – implantation.
If you are a successful candidate then a referral will be sent to a neurosurgeon or orthopaedic spine surgeon for placement of a permanent implant which involves placing a new lead in the spinal canal and the battery generator pack around the buttock area. The implant will not be done for at least a month after the trial to decrease the risk of infection.