Spinal Cord Stimulator Surgery - The risks and recovery time
Here at Southern Pain Clinic, one of the treatments we offer to help our patients manage their pain is a spinal cord stimulator. Spinal cord stimulators are devices that use electrical impulses to block or mask, pain signals before they travel to the brain. In place of the pain, patients feel a far more pleasant and light tingling sensation. In the end, the goal of the spinal cord stimulator is to improve our patients' quality of life while lowering the level of pain they feel.
This small device, similar to a pacemaker, gives our patients control over their chronic pain symptoms and helps decrease the use of opioids. We've seen tremendous results from patients who suffer chronic back, leg or arm pain, where other therapies have been proven unsuccessful.
A spinal cord stimulator is not the ideal solution for every patient. That's why, prior to implanting the device, we perform an outpatient surgical trial procedure. During this trial, we place a stimulator catheter or lead in the area of pain. The patient then can determine if the device provides sufficient pain relief. If it does, then we'll implant the lead and pulse generator.
The trial period also allows our patients to assess whether the sensation they feel - in place of their pain - is something they like. There have been patients who found the sensation to be unpleasant, or who have discovered that the sensation did not cover the entire area of pain.
What you should know about spinal cord stimulators
A stimulator doesn't eliminate the source of pain. What it does is manipulate how the brain perceives that pain. As a result, the level of pain relief felt by each patient can and will vary.
Generally speaking, our goal with our spinal cord stimulators is to reduce the patient's pain by anywhere between 50%-70%, but more is possible.
To determine if you're a candidate for this procedure, our team will evaluate your physical condition, medication regime, and pain history. You stand a good chance of being a candidate if:
- You've tried other conservative therapies, to no avail
- You've had spinal surgery and would not benefit from any additional surgeries, or prefer not to have further riskier surgery
What happens during spinal cord stimulator surgery?
The surgery typically takes up to 2 hours to complete and, is comprised of two parts:
- Placement of the lead in the epidural space of the spine.
- Placement of the pulse generator (in the buttock or abdomen) just under the skin.
During the procedure, you'll be awakened to help the doctor determine how well the stimulator's sensation covers your pain. We'll test out several stimulation settings, and will rely on your input to ensure the procedure results in the best possible pain relief. Following your surgery, you'll be asked to restrict certain activities for 4-6 weeks, including:
- Lifting objects over 5 pounds
- Excessive bending, twisting, stretching, or pulling items toward you
- Raising your elbows above your head
- Sleeping on your stomach
- Excessive sitting
You'll also be asked to restrict driving for up to a month after surgery (or until your surgeon gives you the OK). To help you gradually return to your normal activities, we often recommend taking part in a physical therapy program.
Roughly 10 days following your surgery, you'll come back into our offices to have your sutures or staples removed. At this time, we can adjust the pulse generator's programming (if needed).
Spinal Cord Stimulator therapy is reversible. If at any time you decide that you want to discontinue this therapy, the lead and generator can be removed.
Are there risks to spinal cord stimulator therapy?
Every surgery comes with potential risks. The general complications associated with any surgery include:
- Blood clots
- Bad reactions to anesthesia
Specific risks associated with spinal cord stimulator surgery include:
- Unwanted changes in stimulation
- Spinal cord compression and/or paralysis
- Battery failure or leakage
- Persistent pain at the electrode or stimulator site
- Allergic reaction to the implant materials
- Local skin erosion
- Weakness or numbness below the level of implantation
Quality of life with your Spinal Cord Stimulator
Once your stimulator is programmed, we'll send you home with instructions on how to regulate stimulation. The pulse generator has a few programmable settings only performed by your physician's office, including:
- Frequency (how often the stimulation is delivered per second)
- Width (the coverage area of the stimulation)
- Amplitude (this determines the threshold of perception to pain)
Your handheld programmer will allow you to turn the stimulator on and off, choose your preferred program, and adjust the strength of stimulation or amplitude.
Your stimulator won't be damaged by devices such as smartphones, microwaves, or metal detectors. However, be sure that you carry your Implanted Device Identification card when flying, since the device will be detected at security gates. You might want to turn off your system before passing through department store security gates, as these gates may cause a temporary increase or decrease in stimulation.
There's a lot to consider before - and after - spinal cord stimulation therapy. Contact the team here at Southern Pain Clinic to learn more about this therapy and to determine if it's the right pain management method to improve your quality of life.