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Spinal Cord Stimulation - Surgical Procedure

​During and After the Surgical Procedure​​

Spinal Cord Stimulation is a surgical procedure which involves a 7 day process with two stages:

Stage 1-Trial Stimulation

Trial stimulation is very important to determine if the procedure will be successful. The first stage is completed as an inpatient.

In the operating room, you will be placed on your stomach on the operating table; the team will work to make you comfortable. The area of your back will be cleaned and possibly shaved to prepare for insertion of the leads. You will be given sedation and pain medication to ensure your comfort during the surgery. You will not have a general anesthetic. This will be a very quick procedure.

Placement of the surgical leads is performed. A small incision is made in the midline of your back. The bony arch of your back is exposed and a piece of lamina is removed to allow room for insertion of the leads with the attached wires. The leads are placed in the epidural space and secured with sutures. The inserted wires are then secured outside the body (e.g. externalized) and attached to the temporary pulse generator device which is secured in your posterior pelvic area for your SCS trial to begin. An x-ray may be completed in the operating room or after surgery to ensure proper positioning of the leads in the epidural space.

The nurse practitioner will connect the temporary pulse generator to an external battery pack in order to test the leads and introduce to the feeling of paresthesia (tingling sensation in the area of pain).

The trial period typically occurs over a 7 day hospital stay whereby different programs will be tried and adjusted to identify which program may be right for you.

You will be asked to keep a written log of what you liked, disliked and your pain score while the stimulator is on to help the nurse practitioner make appropriate adjustments throughout your trial.

After Stage 1 Surgery

When the surgery is finished, you go to the PACU for 1 hour to recover. Nurses check your blood pressure, pulse, temperature and breathing often, as you wake up. If you have pain or nausea, they will give you medicines that will help. You may have an oxygen mask over your mouth and/or nose.

When you are ready, you are taken to your room on the Neurosurgery Unit (5A or 5B)

Stage 2: Internalization of wires and insertion of internal pulse generator and battery pack (IPG).
If you and the neurosurgeon have decided after your trial that SCS is not right for you, the wires will be removed and the skin tissue repaired.

If you and the neurosurgeon find that the SCS proves helpful reducing your pain substantially (e.g. lowering your pain by 50% or more), then the second stage will be completed

The second stage occurs while you are back in the operating room and under a general anesthetic (e.g. asleep). Extension wires will be passed under the skin from the spine around the torso to the abdomen or buttock where the pulse generator will be inserted; this choice is up to you.

An incision will be made either lower abdomen or buttock where the surgeon will create a pocket for the generator between the skin and muscle layers. The extension wires are attached to the pulse generator (battery). The battery is correctly positioned and sutured to the area overlying the muscle. The incisions are closed with staples or sutures

Your programs that were trialled in the hospital will be programmed into your device prior to your discharge home.

After Stage 2 Surgery

When the surgery is finished, you go to the PACU for 1 to 3 hours to recover. Nurses check your blood pressure, pulse, temperature and breathing often, as you wake up. If you have pain or nausea, they will give you medicines that will help. You may have an oxygen mask over your mouth and/or nose.

When you are ready, you are taken to your room on the Neurosurgery Unit (5A or 5B).​​​​

How Long Will Your Surgery Take?​

Spinal cord stimulation surgery usually takes 90 minutes to 2 hours.

We do everything that we can to stay on time. Unfortunately, your surgery may be delayed by unforeseen or emergency circumstances.

Neurosurgery Unit

In the Neurosurgery Unit, your health care team continues to check your recovery. You may have back pain, feel pain over your incisions and/or have nausea. This will slowly get better. The nurses can give you medicines for your pain and nausea if you need them.

In the afternoon or evening you can start to drink and eat. Later in the day or the next day, the nurses help you get out of bed and walk. You may feel dizzy, so it is important that someone is with you the first few times you get out of bed.​

Discharge Home

You can expect to go home 1 or 2 days after the second stage of surgery. Please plan for ​someone to take you home before 11:00 am on the day you are discharged home.

Before you leave the hospital, a member of your health care team will review:​

  • Your medications
  • How to care for yourself, what to watch for and how to get help if you need it. The controller for your spinal cord stimulator and a card which has your device information will be sent home with you. Your SCS device will be turned on before you leave the hospital. If your settings are not the same at home after a couple of weeks, this is ok; they can be adjusted in the clinic.
  • Any follow-up appointments. You will see your neurosurgeon 6 to 8 weeks after your surgery. He/she will check the surgical incisions and adjust your SCS device settings, if they are needed. Make an appointment with your family doctor to have your staples removed 10 to 14 days after surgery.​
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Follow these rules for safety when you have a SCS system:

  • Do not have a MRI. Currently the SCS are not MRI safe therefore,​​ if you require a MRI in the future please contact the neurosurgeons office, as the device would have to be removed.​
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