Spinal Cord Stimulators: What You Should Know About a Trial vs. Implant

While there’s a good chance every adult American will experience back pain at some point in their lives, it will most often be a short-lived experience, usually healing in a few weeks or months. Those with chronic back pain, lasting 12 weeks or more, comprise about 20% of cases. As with many neurological ailments, treatment can be difficult. Nerves of the spine are complex, and the origins of chronic pain can be difficult to pinpoint for some.

Spinal cord stimulation (SCS) is one way to treat chronic back pain that isn’t accompanied by an identifiable cause. Similar to pacemakers, SCS devices send small pulses of electricity into the nerves near the source of the pain signals. These pulses alter the way your brain perceives pain from these nerves, and the SCS device can often mask and reduce the pain caused by the errant nerves.  

Trial SCS versus implanted

As effective as SCS can be for some patients, it doesn’t work for everyone. Since long-term solutions are typically needed for chronic back pain to reduce dependency on medications, SCS devices are implanted under the skin to provide ongoing pain relief, a sort of “set and forget” solution.

As a way of gauging the effectiveness of SCS therapy, however, there’s commonly a trial period before permanent implantation. This gives both doctor and patient some idea of the success they can expect through SCS. These stimulators are programmable, so the electrical pulses can be modified for the best results. SCS trials are important for both effective programming and placement for effective pain management.

The SCS trial implant procedure

Going through an SCS trial requires a two-part outpatient procedure. An electrode is placed, typically using a fluoroscope imaging device to precisely locate this thin wire through your skin. The electrode is then attached to an external SCS pulse generator. Several pulse modes are selected, and you’ll be asked for your perceptions of back pain through each option. 

SCS trials usually last for about a week. You’ll keep a pain log to track how the SCS device alters your pain sensations. This could include keeping a record of medications that you take on an as-needed basis. Adjustments may be made through the trial week if sufficient pain relief isn’t achieved.

Permanent SCS implants

When your trial successfully shows that your back pain can be reduced with an SCS device, a permanent implant can be placed under your skin. Once the incision heals, you can function normally, including showering or swimming, activities put on hold during your SCS trial.

Generally, SCS therapy reduces pain by as much as 70%. You’ll likely still have back pain, but your need for medications is typically reduced. The SCS pulses mask pain signals; they don’t eliminate them. SCS therapy may also be combined with other conservative treatments to further reduce your pain burden.

Dr. Desh Sahni is an orthopedic spine surgeon and neurosurgeon by training and Capital Brain and Spine is a practice that specializes in SCS techniques. If you’re one of the 20% suffering from chronic back pain, call the office or request an appointment online for a consultation with Dr. Sahni. 

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