Tunneled Trial of Spinal Cord Stimulation

Abstract This chapter explores the tunneled trial of spinal cord stimulation (SCS). It highlights the importance of the trial being performed in an operating room (OR). Tunneled trials are often the preferred approach for post-laminectomy patients with extensive fusion who are not candidates for traditional percutaneous trials. Surgeons often perform a laminotomy and place a paddle lead in the dorsal epidural space along the anatomic midline. Then, the midline incision and pocket can be created before the placement of leads. The chapter also discusses the conditions, advantages, and disadvantages of placing one or two leads. It recognizes lead migration as the most common cause of mechanical SCS failure.