What is a Spinal Cord Stimulator?
A spinal cord stimulator is a small pulse generator with insulated wires (also called leads) that are implanted into the body on the epidural space in the spinal column. The implanted pulse generator is directed by an external remote control that allows electrical impulses from the pulse generator and the leads to mask pain signals as they travel to the brain. The electrical impulses are perceived by the brain as a gentle, tingling feeling or massage feeling. This feeling is called parathesia.
What is the purpose of a Spinal Cord Stimulator “Trial”?
The purpose of a Spinal Cord Stimulator trial is to “test drive” the implantable device to see if your pain and symptoms are relieved or decreased with this device before having the device permanently implanted into your body.
What areas of pain are Spinal Cord Stimulators effective?
Spinal Cord Stimulators can help manage intractable pain of the trunk and/or limbs (back, arms and legs)-even when other therapies have failed.
Will I be pain-free with a Spinal Cord Stimulator?
People differ in the amount of pain relief they receive with Spinal Cord Stimulator therapy. Many people experience a reduction in pain sensations. The “trial” procedure will help you determine the amount of relief you may receive.
Can one Spinal Cord Stimulator system help me with pain in multiple areas?
Spinal Cord Stimulators are designed to cover several pain areas at the same time. You can use the remote control to adjust the amount of stimulation for each pain area.
Will a Spinal Cord Stimulator allow me to be free of pain medications?
For some patients, the Spinal Cord Stimulator works well enough that pain medications are no longer needed. For others, it can mean a reduction in the amount of pain medication they need. Always consult the physician prescribing your medication before changing your dose.
Do I use my Spinal Cord Stimulator system 24 hours a day?
Yes, that is up to you. You can use it as much as 24 hours a day or as little as a few hours a day. The amount of pain control that you need will determine how often you use the system.
Do Insurance plans cover Spinal Cord Stimulators?
Spinal Cord Stimulators are covered by most health insurance plans including Medicare.
Will I be "put out" for this procedure?
No. This procedure is done under local anesthesia. Injection of a medicine like Novocaine-Lidocaine is performed to numb the skin. Some of the patients also receive intravenous sedation, to help them relax and make the procedure easier to tolerate. The amount of sedation given depends upon the patient. You can be sleepy while the procedure is being performed, will need to be awake enough to tell the doctor and the representative what you are feeling.
How is a Spinal Cord Stimulator Trial performed?
The procedure is done in the Procedure Room with fluoroscopic (x-ray) guidance. The x- ray allows the physician to see the placement of the leads to ensure the placement will ensure maximum masking of your pain/symptoms.
There will be a nurse present during the procedure to monitor you and administer intravenous sedation to help you be comfortable and relaxed. You are watched closely with a blood oxygen-monitoring device. A representative with the company supply the generator/leads will be present to customize the programming to mask your pain/symptoms.
The skin over the injection site(s) is cleaned with an antiseptic solution. The skin is then numbed with a medication before the procedure begins. This will feel like a small bee sting. A small incision is then made. The lead(s) are then inserted and placed along side the spinal column. This takes few minutes to complete. The physician uses the x-ray guidance to view the placement of the leads. Once the lead(s) is placed in the desired location the generator is then attached and a series of tests with the pulse generator are carried out. The physician, the representative and the patient communicate together throughout the programming stage to ensure the pain/symptoms are being stimulated prior to finishing the procedure. Once the desired results are obtained the physician will tape the leads to the skin.
The patient will be taken to the recovery area and then the representative will explain how to use the Spinal Cord Stimulator. During this time the patient will learn how to use the remote control to turn the impulses up and down. Questions and concerns are gone over until the patient feels comfortable with using the stimulator. Individualized programs are then created based on your needs.
What will I feel during the trial?
You will feel a sense of pressure in the back throughout the procedure. Once the lead(s) is placed the programming will begin. You will feel “tingling” sensations in various areas while the programming is being tested.
How long does a Spinal Cord Stimulator Trial take?
This procedure takes approximately 45 minutes to an hour depending on the ease or difficulty getting the leads into the correct position.
What should I do after the procedure?
You will need a ride home. We advise the patients to take it easy the day of the procedure. You may need to apply ice to the affected area for 20-30 minutes at a time for the next day.
Use the stimulator enough to determine whether it is an improvement in your life. Decreased pain perception, increased activities that were pain limited, decreased pain medication use and decrease in depressed mood from pain are all signs that the stimulator trial is effective and a permanent system should be implanted.
What are the risks and side effects of a Spinal Cord Stimulator?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. These will be thoroughly discussed in person with your physician.
What if the trial is effective?
You will be referred to a spine surgeon for permanent implant of a different kind of lead and a batter/pulse generator. The surgical type of lead has a much greater ability to stay in place and not shift which would cause loss of stimulation coverage. The pulse generator is placed just under the skin like a pacemaker battery and can be recharged and controlled from a handheld radio unit that you will receive.