Spinal Cord Stimulation (SCS) Therapy
The Trial — Testing SCS Before You Commit
The Ability to "Try Before You Buy"
One of the greatest advantages of SCS is that you can test it before committing to a permanent implant.
This is called a trial or trial stimulation.
Two Types of Trial
There are two approaches: a percutaneous trial (needle-based) and a surgical trial (open approach). The method used depends on the facility and physician.
Percutaneous Trial (Needle-Based)
The leads are inserted through a needle directly through the skin, without a surgical incision. The leads themselves exit through the skin and connect to an external stimulator for the trial period.
Surgical Trial (Open Approach)
A small incision (about 5–7 cm) is made to insert and secure the leads in a subcutaneous pocket. The leads remain inside the body, and only an extension cable exits through the skin at a separate site. This approach is designed with the permanent implant in mind from the start.
Comparing the Two Approaches
| Percutaneous Trial | Surgical Trial | |
|---|---|---|
| Skin incision | None (needle only) | About 5–7 cm |
| Surgical burden | Light | Somewhat greater (about a week of incision discomfort) |
| Hospital stay | Some facilities allow same-day discharge | Hospital stay required (1–2 weeks) |
| Transition to permanent implant | Leads are removed and new leads must be placed | The same leads are used for the permanent implant |
| Consistency of stimulation | It may not be possible to place new leads in the exact same position, so the stimulation pattern may differ from the trial | Same leads are used, so the trial experience is faithfully reproduced |
| Programming adjustments during trial | Manufacturer support for adjustments may be limited | Manufacturer representatives can provide detailed, fine-tuned adjustments |
The supervising physician of this website uses the surgical trial approach. While the surgical trial involves a slightly larger procedure, it allows the same leads to be used for the permanent implant, ensuring that the benefit experienced during the trial carries over seamlessly.
The approach used varies by facility and physician. Please ask your doctor which method is used at your institution.
How the Trial Works
| Step | What Happens |
|---|---|
| 1 | Under anesthesia, thin leads are inserted through the back and positioned near the spinal cord |
| 2 | The leads (or extension cables) exit through the skin and connect to a temporary external stimulator |
| 3 | Over approximately one week, you test the therapy in a hospital setting. Manufacturer representatives help fine-tune the stimulation |
| 4 | Results are evaluated |
Based on the results:
- Effective (50% or greater pain reduction) --> Proceed to permanent implant
- Not effective --> The leads are simply removed (with virtually no lasting effect on the body)
Benefits of the Trial
| Benefit | Explanation |
|---|---|
| Confirm effectiveness first | You know whether it works before committing |
| Low risk | If it doesn't work, the leads are simply removed |
| Real-world testing | You can evaluate the therapy during your daily activities |
| Informed decision-making | You experience it yourself before making a final decision |