Spinal Cord Stimulator for Diabetic Neuropathy

Spinal cord stimulator device.

The spinal cord stimulator trial can be thought of as a test drive of the implantable device. Not every diabetic neuropathy patient finds pain relief when treated with spinal cord stimulation, so the trial is standard practice to ensure that a long-term device implant makes sense for you. During a spinal cord stimulator trial, the implant is not fully implanted, but the leads are inserted into your body and connected to an external pulse generator.

The spinal cord stimulator trial procedure is done with the patient lying face down. A small incision is made on the back under local anesthesia, and a hollow needle is inserted into the incision and guided towards the treatment area. An X-ray is used to visualize the anatomy and direct the placement of the needle into the epidural space of the spinal canal. The leads (wires) are passed through the hollow needle and attached to the treatment area.

After the leads are placed, the spinal cord stimulator is turned on, allowing the patient to experience the sensation of the stimulator. The surgeon will ask the patient if the stimulation is hitting the right areas where pain is frequent, and will adjust the stimulation settings until the patient agrees that the settings are sufficient.

During recovery, the patient will then receive a brief demonstration on how to adjust the stimulation settings. The patient is sent home on the same day, beginning the trial period. Around 7 days later, a decision is made on whether or not to proceed with the final spinal cord stimulator implant. If the patient does not wish to proceed with the implant, the leads will be removed at the conclusion of the trial period.

It is normal to experience pain following the implant procedure, particularly at incision sites, where the IPG was placed, or where the hollow needle was inserted. [1] In some cases, patients may be advised to avoid activating their spinal cord stimulator until swelling subsides. Spinal cord stimulator surgery is an outpatient procedure, so patients are typically discharged the same day. In most cases, patients can gradually increase activity after two to three weeks, but complete spinal cord stimulator recovery from the surgery may take up to eight weeks, and certain activities may be restricted even longer to avoid disrupting the components of the spinal cord stimulator.