A spinal cord stimulator (SCS) trial is a temporary test procedure that lets you experience spinal cord stimulation before committing to a permanent implant. During a 5-7 day trial, thin leads are placed in the epidural space and connected to an external battery worn on a belt or in a pocket.
Conditions treated include failed back surgery syndrome, chronic radiculopathy, complex regional pain syndrome (CRPS), peripheral neuropathy, and chronic intractable pain of the trunk or limbs.
The trial is considered successful if you achieve 50% or greater pain relief. Trial success rates are 70-80% in properly selected patients.
Under conscious sedation and fluoroscopic guidance, one or two small epidural leads are placed in the posterior epidural space at the appropriate spinal level. The leads exit through the skin and connect to an external trial stimulator. Patients are instructed on how to adjust stimulation settings using a handheld remote.
During the trial period, patients maintain a pain diary documenting the degree of pain relief, changes in medication use, and improvement in quality of life. This data helps determine whether a permanent implant is appropriate.
The trial placement procedure takes approximately 30-60 minutes and is performed on an outpatient basis. Patients may return home the same day with the external stimulator.
Activity restrictions during the trial period include no bending, twisting, or lifting more than 5-10 pounds to prevent lead migration. Most patients can work, drive, and perform normal daily activities.
There is minimal recovery from the trial placement itself. The leads remain in place for 5-7 days. At the end of the trial period, the leads are removed in the office — a quick and simple process.
If the trial is successful (50%+ pain relief), a permanent implant can be scheduled. If not, the leads are removed with no permanent changes to the spine or nervous system.
SCS is indicated for patients with chronic neuropathic pain who have failed conservative management. Contraindications include active infection, untreated coagulopathy, and inability to operate the device. Psychological evaluation is often recommended before proceeding with a trial.
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