Spinal Cord Stimulation

1. What is a Spinal Cord Stimulator?

Spinal cord stimulation involves the placement of electrodes near the spinal cord that send electrical current to the spinal cord to change pain messages being sent to the brain. Studies have shown that spinal cord stimulation also works in several other ways to decrease pain.

2. Steps

Before a spinal cord stimulator is implanted, there are several steps that must take place. First, a patient must undergo psychological evaluation; most insurance companies require this. If approved, a spinal cord stimulator trial (typically lasting 5-7 days) is performed with temporary electrodes and an external battery. If the patient has significant pain relief and functional improvement, an implant is offered. The implant involves anchoring the stimulator leads and placing an internal battery.

3. The Trial

You will be positioned on your abdomen. Your heart rate, blood pressure, and oxygen level will be monitored during the procedure. An IV will be placed. The injection site will be washed with a sterile cleaning solution. X-ray images will be taken of your spine to determine the correct placement of the needle and the stimulator leads.

Local anesthetic (“numbing” medication) will be injected into the skin. X-ray images and testing (typically a vibration type sensation) will be used to confirm the location of the stimulator leads in the epidural space.

Once the leads are in place, the needles will be removed and large dressings will be placed over the area where the stimulator leads come out of the skin.

4. The Implant

You will be positioned on your abdomen. Your heart rate, blood pressure, and oxygen level will be monitored during the procedure. An IV will be placed and light sedation will be given by an anesthesiologist. The injection site will be washed with a sterile cleaning solution. X-ray images will be taken of your spine to determine the correct placement of the needle and the stimulator leads.

Local anesthetic (“numbing” medication) will be injected into the skin. Two small incisions (about 5 to 7 cm long) will be made, one in the mid-back for the leads and one in the flank for the battery. X-ray images and testing (typically a vibration type sensation) will be used to confirm the location of the stimulator leads in the epidural space. You will be awake for the testing period.

Once the leads are in place, the needles will be removed. The leads will then be anchored to the muscle and connected to the internal battery. Dressings will be placed over the incisions.

5. Driving

You will not be able to drive during your trial week or for 2-4 weeks after your implant. Sudden movements while driving can make the stimulator leads move position, decreasing their effect on pain control.

6. Before the Procedure

It is important that you follow all pre-procedure instructions given to you at your clinic visit; if not, your procedure may be canceled.

7. After the Procedure

You will remain in the recovery room for observation; we will monitor your vital signs during this time. The staff will give you discharge instructions.

During your trial, you will follow up in clinic twice. We will remove your stimulator leads in clinic after your trial.

After your implant, you will follow up in our clinic.