Spinal cord stimulation (SCS) surgery is most commonly performed in two separate steps—a trial procedure and a permanent implant.
The stimulation trial usually requires a short procedure. This procedure is often performed on an outpatient basis at a hospital, pain clinic, or at a day surgery center. The trial implantation may be performed under light sedation or, less frequently, under general anesthesia. Often, all that is needed is a local anesthetic to numb the area where the leads are inserted.
During the procedure, one or more leads are placed in the space along the spinal cord. The leads are typically inserted using a needle. The exact placement depends upon the location of your pain. When the leads are positioned in the best location, they are connected to a portable, external generator. Once connected, the system generates mild electrical pulses that will be programmed to replace your areas of intense pain with a more pleasant sensation known as paresthesia.
Your doctor determines the length of the trial period. It may last for only a few days or several weeks. A longer trial may allow you to test how well you respond to stimulation throughout the day while a shorter trial can be appropriate if your response is immediate and pain relief is dramatic.
When you get home, you will be able to test how well the stimulation helps control your pain throughout the day and during different activities. You will jot down notes in your trial diary to track which program(s) you use and how the stimulation covers your pain. Several days or more after the procedure, you will either return to your doctor's office for a follow-up visit or a member of the doctor's staff will call you to see how you are doing.
If your trial is successful and you and your doctor decide to go forward with a permanent SCS system, it can be the beginning of an exciting time in your life. With SCS, you may be able to do more of the things you really want to do. And it may be a major step toward a healthier, more active and fulfilling lifestyle.
If the spinal cord stimulation (SCS) trial provides enough pain relief, you will probably be scheduled to have the permanent system placed. Remember, even though an SCS system is called permanent, spinal cord stimulation is a reversible therapy. If you want to discontinue treatment at any time, the implanted parts can be turned off or removed.
Similar to the trial, the permanent implantation requires a relatively short surgical procedure. Although procedure times vary, typical times range from one to two hours. This procedure, like the trial procedure, is often performed on an outpatient basis or at a day surgery center. The procedure may be performed under light sedation or general anesthesia. Your doctor will select the appropriate type of anesthesia for you.
The generator will be placed in the area of the body that you and your doctor have agreed upon. Leads will be placed along the spinal cord and attached to a generator. Bandages will be applied.
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