What is a Stimulation Trial?
- Before being implanted with a Spinal Cord Stimulator (SCS) or Peripheral Nerve Stimulator (PNS) or Occipital Nerve Stimulator (ONS), you must first undergo a stimulation trial procedure.
- The trial procedure involves surgical insertion of stimulating leads - either along the spinal cord, or next to a peripheral nerve, or the occipital nerve. Stimulation testing is conducted in the operating theatre, followed by an evaluation period at home that may last for 7-10 days.
- This trial period enables you to evaluate the effectiveness of the therapy in reducing your pain and, should the trial be successful, allows your doctor to assess your device requirements before receiving an implant.
- This procedure is always performed in the operating theatre using X-ray guidance.
- For more information on spinal cord / peripheral nerve stimulation, read our educational news article on Neuromodulation for Chronic Pain.
Prior to the Procedure
- All blood thinning products (except aspirin) must be stopped prior to your procedure. A nurse from Hunter Pain Clinic will advise you by letter when to stop taking these medications at the time that your admission date is arranged.
- You are able to take your other regular medications with a sip of water on the morning of your procedure.
- If you are an insulin dependent diabetic you will always be at the beginning of the list. Please bring your insulin with you and it will be given to you following your procedure.
- Hamilton Day Surgery Centre staff will advise you prior to your procedure of your fasting and admission time.
- You must not have anything to eat, drink, smoke or chew six (6) hours prior to your procedure.
- You will need to organise someone to drive you home after the procedure as you will not be able to drive for 24 hours after your procedure.
What Will Happen?
- You will be admitted to the day surgery by a nurse and you will be asked to change into a gown.
- The anaesthetist will speak with you and place a cannula (plastic needle) into a vein in your hand.
- In the procedure room, you will be assisted to position on the procedure table on your abdomen with a pillow under your hips and abdomen.
- The anaesthetist will give you some sedation into your vein.
- An X-ray machine will be used during this procedure.
- The entire procedure will take around 30 to 60 minutes to complete.
- An introducing needle will be placed into your epidural space or under the skin in your painful area. Once correctly positioned, the stimulation lead will be threaded into place.
- Upon correct positioning of the lead, the lead will be hooked up to a stimulation box and stimulation testing will take place to ensure your pain areas are covered.
- Once correct stimulation has been achieved, a dressing will be placed on your back.
- After the procedure, you will be placed on a trolley and taken to recovery, where you will remain for approximately 1 hour.
- Prior to going home, you will be seen by the technician who will give you written and verbal instructions on how to use your stimulation unit.
- After having something to eat and drink, you will be discharged with a carer.
- Your back will be sore at the insertion site for around 48 hours.
- It is important that you stick to the restrictions outlined in the education session.
- No lifting, no stretching, no twisting and no bending more than 45 degrees.
- It is important that your carer check your back each day for any sign of infection – redness, swelling or discharge.
- If this is noted it should be reported to the pain clinic nurses straight away.
- It is important not to shower or allow your dressing to become wet during your trial.
- Should your dressing become wet, it will need to be changed as soon as practical.
- You need to use the stimulator to establish if it is assisting with your pain relief.
- A nurse from HPC will telephone you each day to check on your progress.
- If you have any concerns you should contact Hunter Pain Clinic or the stimulator company representative.
- Generally, you will have a follow-up appointment 7 days after commencement of the trial.
- At this time, the effectiveness of the stimulator in relieving your pain will be assessed by your doctor.
- The leads may be X-rayed then removed by your doctor or nurses either at Hamilton Day Surgery or at Hunter Pain Clinic.
- You will then be able to resume all normal activities.
If you require further explanation of the procedure, please contact Hunter Pain Clinic nursing staff on (02) 4985 1800.
* Image adapted from Mconnell. distributed under a CC BY 3.0 license. https://commons.wikimedia.org/wiki/ File:Anterior_thoracic_SCS.jpg