Long-term (chronic) back pain, with or without arm or leg pain
Nerve pain or numbness in the arms or legs
Swelling (inflammation) of the lining of the brain and spinal cord
SCS is used after you have tried other treatments such as medicines and exercise and they have not worked.
Risks
Risks of this surgery include any of the following:
Cerebrospinal fluid (CSF) leakage and spinal headaches
Damage to the nerves that come out of the spine, causing paralysis, weakness, or pain that does not go away
Infection of the battery or electrode site (if this occurs, the hardware usually needs to be removed)
Breaking of the wire that may require more surgery
Movement of or damage to the generator or leads that requires more surgery
Pain after surgery
Problems with how the stimulator works, such as sending too strong of a signal, stopping and starting, or sending a weak signal
The stimulator may not work
Collection of blood or fluid between the covering of the brain (dura) and the surface of the brain
The SCS device may interfere with other devices, such as pacemakers and defibrillators. After the SCS is implanted, you may not be able to get an MRI anymore. Discuss this with your surgeon.
Before the Procedure
Tell your surgeon or nurse if:
You are or could be pregnant
You are taking any medicines, including drugs, supplements, or herbs you bought without a prescription
During the week before your surgery:
You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
Ask your surgeon which medicines you should still take on the day of surgery.
Prepare your home for when you come back from the hospital.
If you are a smoker, you need to stop smoking. Your recovery will be slower and possibly not as good if you keep smoking. Ask your provider for help quitting.
Talk with your surgeon if you have been drinking a lot of alcohol.
On the day of surgery:
Follow instructions about when to stop eating and drinking.
Take the medicines your surgeon told you to take with a small sip of water.
Arrive at the hospital on time.
Bring your cane, walker, or wheelchair if you have one already. Also bring shoes with flat, nonskid soles.
After the Procedure
After the permanent generator is placed, the surgical cut will be closed and covered with a dressing. You will be taken to the recovery room to wake up from the anesthesia.
Most people can go home the same day, but your surgeon may want you to stay overnight in the hospital. You will be taught how to care for your surgical site.
You should avoid heavy lifting, bending, and twisting while you are healing. Light exercise such as walking can be helpful during recovery.
Outlook (Prognosis)
After the procedure, you may have less back pain and will not need to take as much pain medicines. But, the treatment does not cure back pain or treat the source of the pain. The stimulator can also be adjusted depending on your response to the treatment.
References
Burke JF, GilliganIn CJ, Poree L. Neuromodulation and rehabilitative interventions for the spine. In: Steinmetz MP, Berven SH, Benzel EC, eds. Benzel's Spine Surgery. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 76.
Dinakar P. Pain management. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 52.
Levin E, Sagher O. Spinal cord stimulation. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 204.
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