Following a successful trial, permanent spinal cord stimulator leads and a rechargeable or non-rechargeable battery (implantable pulse generator) are surgically placed. This provides long-term pain relief for patients with chronic neuropathic pain conditions.
In the operating room, leads are placed in the epidural space under fluoroscopic guidance, anchored, and tunneled under the skin to the battery implanted in the upper buttock or flank area.
Non-rechargeable batteries last 3-5 years; rechargeable batteries last 9-15 years before replacement is needed. Activity restrictions apply for 6-8 weeks after implantation to allow proper healing.
The permanent implant procedure is performed under conscious sedation or general anesthesia in an operating room setting. The leads are placed in the epidural space at the appropriate spinal level, then tunneled subcutaneously to the implantable pulse generator pocket created in the upper buttock or lower abdomen.
The generator delivers programmed electrical impulses to the spinal cord that modulate pain signals before they reach the brain. Patients control stimulation parameters using a handheld remote or smartphone application.
The implant procedure takes 1-2 hours. Patients go home the same day or stay overnight for observation. The incision sites are closed with sutures or surgical adhesive and covered with sterile dressings.
Pain relief is typically immediate upon activation, though a healing period is needed before the full benefit is appreciated. The stimulator is usually activated 1-2 weeks after surgery.
Activity restrictions for 6-8 weeks include no bending, twisting, lifting over 5-10 pounds, or reaching overhead. Patients can return to desk work within 1-2 weeks. Driving is permitted after the surgeon confirms it is safe.
MRI compatibility depends on the specific system used. Most modern SCS systems are MRI-conditional, allowing full-body MRI under specific conditions.
Permanent SCS implantation is offered only after a successful trial period. The procedure is contraindicated in patients with active infection, untreated coagulopathy, or conditions that would interfere with proper device operation or wound healing.
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