![]() ![]() Once the leads are placed, they are connected to an external battery and covered by a large bandage. A physician will use a small needle to place two temporary leads for the spinal cord stimulator along the area of the spine that correlates with your pain. When you are brought into the procedure room, nurses will clean your skin at the injection sites and apply a local anesthetic to numb your skin. After being admitted, you will receive sedation through an IV prior to the procedure. The SCS trial procedure is performed by a physician at an outpatient surgery center. The spinal cord stimulation procedure is broken up into two parts, a trial period and the permanent implant. Spinal cord stimulation has proven to be a very effective treatment for relieving pain from a variety of conditions, including failed back surgery, sciatica, spinal stenosis, epidural fibrosis, and diabetic peripheral neuropathy (DPN). This innovative technique is capable of providing at least as much relief as opioid medications, without the negative side-effects. Pain is reduced because the electrical pulses modify and mask pain signals before they reach the brain. The leads apply the electricity to the nerves, “stimulating” them. The battery emits mild electric pulses which are carried to the nerves by the leads. The leads are then connected to the battery, which is implanted into a small pocket in the lower abdomen. The leads are placed along the spine, next to the nerves causing pain. A stimulator consists of two parts, a battery and a pair of thin leads with electrodes on the tips. The device that performs stimulation therapy is called a spinal cord stimulator. Any significant local pain should be reported to the doctor.Spinal cord stimulation is primarily prescribed for patients who have tried conservative therapies and experienced inadequate pain relief, would not benefit from additional surgery, or do not want to pursue surgery due to risks or long recovery. The site on the back where the leads and electrodes were inserted is usually uncomfortable for a few days. If the pain is not relieved, the doctor should be contacted right away so the device can be reprogrammed. The doctor may ask the patient to track which stimulation settings are used at different times and how well the pain was relieved.With some models, adjustments are needed for significant body movements, such as getting up or lying down. The controller offers a range of adjustments in the intensity and duration of stimulation. The patient is given the controller and can turn it on to send pulses of current to the electrodes as needed.A hand-held controller to adjust the amount of stimulation is programmed by the doctor based on the earlier feedback from the patient during adjustment of the electrical contacts.The patient is given time to recover from the procedure before going home.See Rechargeable Spinal Cord Stimulators for Chronic Pain The wire connecting to the external neurostimulator is taped to the person’s back during the trial to hold it in place. The leads are connected to an exterior pulse transmitter that the patient wears on a belt.Once the patient has reported on the pain-relief coverage, the patient is again sedated. Devices using newer technology generally avoid the tingling sensation and a wake-up test may not be needed.) Each electrode affects pain in a different area, so doctor-patient communication is crucial in making sure the doctor has adjusted the location of the electrical contacts to cover all the areas in pain. (If a low-frequency system is used, the goal will be to cover all painful areas with a slight tingling sensation known as paresthesia. The patient is awakened to provide feedback on the specific areas where pain is relieved by the stimulation, and where pain relief is still required. ![]() See Introduction to Diagnostic Studies for Back and Neck Pain In some cases, a small incision may be needed to insert the needle. The needle contains thin, insulated wires, called leads, with electrical contacts attached. Guided by fluoroscopy (a type of X-ray), the doctor inserts a hollow needle into the area around the spinal canal called the epidural space.Local anesthesia is applied to the injection site and sedation may be provided.Procedures vary somewhat with the stimulation device used, but these are the typical steps. The trial period procedure is usually performed in a doctor’s office or a surgical center. ![]()
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