PERMANENT SPINAL CORD STIMULATOR (SCS) IMPLANTATION
Permanent spinal cord stimulator implantation is a surgical procedure used to treat chronic back and/or leg pain. Utilizing the theory of pain signal transmission, the spinal cord stimulator delivers low level electrical impulses which interfere with the transmission of pain signals to the brain. Typically, patients feel a slight tingling sensation in the locations where they once felt moderate to severe pain. Before a permanent stimulator is implanted, however, a temporary stimulator is surgically inserted to make sure adequate pain control is attained.
The Procedure:
The procedure involves a mid back incision through which a small amount of bone is removed (i.e. laminotomy), allowing access to the spinal cord. A paddle lead is inserted directly over the spinal cord and once positioned correctly, it is secured down to the surrounding muscles with sutures. The procedure is completed under local anesthesia so that you are able to answer questions regarding the areas you feel stimulation. Therefore, once implanted, the stimulation system is turned on and you will be asked various questions. It is very important during surgery to communicate if you are feeling stimulation in all the areas where you typically feel pain.
A second incision is made in the flank area which houses the rechargeable battery. The lead is then connected to the battery and both incisions are closed with absorbable sutures and dermabond.
Pre-operative testing and preparations:
Prior to your surgery date, you will be required to undergo routine laboratory tests, EKG and a chest x-ray. If you are over 50 years of age or have any history of cardiac or pulmonary problems, you will also be required to have a clearance by a cardiologist or pulmonologist, respectively. You will also be given information on what medications, both prescription and over the counter, that need to be discontinued pre-operatively as many can interfere with wound healing and bleeding time.
What to expect in the hospital post-operatively:
You will wake up in the recovery room after the operation is over. During this time you may be disoriented and tired, which is the normal effects of the anesthesia wearing off. Once stable, you will be taken to your room where you may be greeted by family and friends.
You will be visited by someone in the recovery room who will help you program your stimulation system. Using a programming device located outside the body, you will be shown how to turn the device on and off as well as change the area and intensity of stimulation. You will have control of the programming. Instructions regarding charging the battery using a device held over the skin will also be provided.
Both your incisions will be covered by a sterile dressing. Patients typically stay in the hospital overnight. Before your discharge, you will be provide with a list of “do’s and don’ts.”
Once you arrive home:
Continue to walk with your brace and slowly increase your activity level. Light exercises are encouraged.
No bending, stretching or twisting.
No lifting greater than 10 pounds.
You may shower, but do not soak in the bath or hot tub for 4 to 6 weeks.
Once the dressing is removed and you are informed to keep it open to the air, make sure that you protect it from sun exposure. Once the incision is healed, sunscreen should be on the incision for 6 months to one year. This will help decrease its appearance.
Maintain a healthy diet, especially one that is high in dietary fiber to decrease constipation. Additionally, a diet rich in protein is ideal for the healing process. Drink plenty of fluids.
Monitor your incision. It is common to have a small amount of blood and fluid leakage, however, if there is persistent drainage contact the office. Additionally, watch for opening of the incision, redness or warmth around the incision, or fever greater than 101ºF.
No driving for 1 to 2 weeks or until advised. Continue to walk and slowly increase your activity level.
<< BACK TO SPINE SURGICAL INFORMATION