Frequently Asked Questions Prior to a Spinal Cord Stimulator Trial

Why may I be a good candidate for a SCS?

When your pain is chronic, severe and neuropathic in nature Pain effects your quality of life.

When surgery, injections, physical therapy, medications, and other treatments have failed to give enough relief of pain.

What is the recovery time?

Your trial is a minimally-invasive procedure and will not require recovery time per say. At first, you will have lifting, bending and twisting restrictions to protect your temporary battery however, you are encouraged to participate in usual activities as oppose to bed rest to appreciate the real benefit from your temporary implant.

Why can I not go straight for the permanent implant?

The trial period is similar to long-term therapy, except that the device transmitting current is not implanted in the body. Instead, just the wires are inserted and an external transmitter sends electrical pulses to the electrical contacts near the spinal cord. Trials are completely reversable and cause minimal side-effects. Completing a trial allows you to determine if the therapy plan is a good option to manage your chronic pain. It also allows to understand whether areas of pain are covered with the stimulation and whether it is causing any side effects. These can be addressed during final implantation.

What are the potential complications?

SCS has become an established treatment option for controlling chronic because its reversibility, minimal invasiveness, low complication rate and effectiveness. Complications are uncommon, but you should know what to watch for it they occur.

A drawback is that the therapy may not produce the desired results for every patient. This is why a trial is carried out in a two-phase process- a trial followed by a permanent implant. For a patient to have a successful trial, it is important that a <%50 pain reduction is reported post-trial.

Lead migration, untoward stimulation and infection are rare, they can occur. You will be administered antibiotics during procedure to prevent the risk of infection. We will closely follow your care during your trial should you experience any other issues.

What about work?

We will provide sick leave for the length of your trial. You will receive sick leave again if you proceed for a permanent implant. Please inform your preoperative nurse or our coordinator to assist you with this. How quickly you return to work is dependant on you. You are the best to decide how well you feel and your limitations.

General information

Office Hours are Monday – Friday 8:00am – 4pm.

Should you have any problems during your trial or there after email: Cassidl@clevelandclinicabudhabi with your problem or number and we will reply ASAP. If after hours, you can contact the contact centre or communicate with your CCAD app.

Agreement of placement.

From here, a team will be involved in monitoring your care.The team consists of the surgeon, Physician, Nurse coordinator and potentially physician assistant. The patient, family members, and caregivers are also important members of the team.

Work up for procedure:

Pre-anaesthesia clinic maybe required depending on any co-morbidities. This is rare and your physician will inform you if this is required.

A COVID test is mandatory prior to procedure. It is usually 72 hours before. The preanesthetic clinic will follow up with you regarding the most recent COVID protocols.

Medications:

Kindly STOP the following medicines 7 days before your procedure:

• Non-steroidal anti-inflammatory drugs (for example: Ibuprofen, Naproxen)
• Vitamins, diet pills, and herbal medicines.
• If you realize you're taking one of the blood thinning medications listed below because of a heart condition, stroke or blood clot history: YOU MUST contact your surgeon and PAT Clinic to receive instructions.

Laboratory bloods maybe required if you take any blood thinners to ensure coagulation is in safe parameters. You will be required to stop anticoagulation medications such as Plavix, aspirin and warfarin. If you have a question regarding medication instructions prior to surgery, please contact us to clarify instructions.

The night before:

No food, chewing gum or milk should be consumed 8 hours prior to procedure. Sips of water can be taken 2 hours before you scheduled surgical time. This is extremely important for your safety. Not adhering will result in cancellation/ rescheduling on the day.

This procedure does not require admission to the hospital.

Please organise a family member or friend to take you home the same day as per the UAE law you will be unable to drive post anaesthesia. Please organise a family member or friend to take you home the same day.

What to Bring to the hospital:

• List of current medications and with time and dosage information.
• A CPAP machine if applicable.
• Wear loose fitting, comfortable clothing that does not fit tightly over area of temporary battery or wound if proceeding .
• DO NOT bring non-essential valuables to surgery centre/hospital.
• DO NOT wear contacts the day of surgery; wear your glasses.

Prior to your procedure you can optimise your recovery by:

• Reducing or stopping cigarette/e-cig smoking (can delay your wound healing and recovery).
• Optimize blood sugar for diabetic patients (should be within parameters).
• Improving other medical conditions to make sure they are stab

On the day:

Your surgical co-ordinator will provide a time for you to arrive, this is usually 1-1 hours prior to your procedure. The reason for this is complete safety checks and complete any outstanding testing (example: blood test) if required.

It is mandatory for you and your family members to have a green pass on your Al Hosn app to enter the hospital.

When You Arrive at the Facility:

Please take D elevator to level 2. Please make your way the pre- anaesthesia check in desk were the staff will assist you.

Anaesthesia and you:

To help ensure your comfort, anaesthesia will be administered before and during your procedure. If you have experienced motion sickness and/or nausea in the past, please inform our anaesthesiologist before your surgery. Your anaesthetic will induce sleep with medications given through your IV. Ensuring that you're well-informed the anaesthesiologist will meet with you prior to surgery. This is a great time to discuss past experiences with anaesthesia or questions and concerns you may have.

Ensuring that you're well-informed:

The doctor will see you prior to procedure and complete consent forms. Any further questions regarding the trial can be asked at this stage.