Spinal Cord Stimulator Trial/Implant

What is a Spinal Cord Stimulator (SCS)?

A spinal cord stimulator is a unique medical device that allows for electrical stimulation of the spinal cord aimed at blocking pain.  Small, thin trial lead wires are placed within the epidural space overlying the dorsal or back side of the lower thoracic spinal cord.   Small electrodes are located at the tips of the trial leads which then transmit electrical pulses directly over the spinal cord.  The electrical current blocks chronic neck or back pain, arm or leg pain.

Am I an appropriate candidate for a Spinal Cord Stimulator Trial?

This technology is reserved for individuals with chronic and intractable pain of the neck, back and/or limbs unresponsive to lesser invasive treatments.  Indications for a spinal cord stimulator trial may include any of the following conditions:  Failed back surgery syndrome; chronic radicular limb pain; complex regional pain syndrome; arachnoiditis.

How is the SCS trial lead placement actually performed?

The process is simple and takes usually no more than 30 minutes, often under light conscious sedation.  SCS leads are placed into the epidural space by way of an introducer needle with the assistance of fluoroscopic x-ray guidance.  A small external electrical generator is programmed to best capture as much of the painful area as possible.  When accomplished, the introducer needle(s) are removed.  The exposed SCS leads are then secured to the skin with one or two stitches and a bandages.   

What determines a successful SCS trial?

Diminished pain levels, improved function and lower pain medication requirements during a 5 day trial period.

What happens following a successful SCS trial?

The trial leads are easily removed at time of office follow up and one is given the opportunity to proceed with a permanent spinal cord stimulator implantation with anticipated benefits of long term pain relief, improved quality of life, elimination or substantially reduced pain medication.  

Permanent SCS implantation

During the permanent implantation procedure, the generator is placed under the skin and the trial leads are replaced with sterile electrodes.  Unlike the trial electrodes, these will be anchored by sutures to minimize movement.  The implantation procedure takes approximately two hours and is performed as an outpatient surgery. 

After the local anesthesia has been administered, your surgeon will make one incision over your lower upper buttock to hold the generator and another incision along the spine to insert the permanent lead electrodes.  The incisions are on average 2-3 inches in length.  As in the trial procedure, fluoroscopy is used to guide the process.  Once the electrodes and battery are placed, your surgeon closes the incision with sutures.