A spinal cord stimulator (SCS) is an implanted medical device designed to help manage chronic pain that has not responded to other treatments. This device works by sending low levels of electricity to the spinal cord, which can interfere with pain signals traveling to the brain. A common concern among patients is whether the internal battery component, known as the implantable pulse generator (IPG), can shift from its original position. This article explores the typical placement of the SCS battery, factors contributing to its movement, how to identify it, and steps for addressing and preventing displacement.
Spinal Cord Stimulator Battery Placement
The implantable pulse generator (IPG), housing the battery, is typically placed in a discreet location within the body. Common sites include the lower abdomen, upper buttocks, or occasionally the upper chest area. These locations are chosen for accessibility, comfort, and cosmetic considerations.
During implantation, the surgeon creates a small pocket under the skin to house the IPG. The device is often anchored with sutures to surrounding fascia or muscle to minimize immediate post-operative movement. Over time, scar tissue forms around the IPG, further stabilizing it within this pocket.
Reasons for Battery Migration
Despite careful surgical placement, several factors can contribute to the spinal cord stimulator battery shifting from its original site. Excessive physical activity in the early post-operative period, before the surgical pocket has fully healed, is a factor. Vigorous movements, stretching, or lifting can exert forces that dislodge the IPG.
The design and depth of the surgical pocket play a role; a pocket that is too large or shallow may not provide sufficient constraint, allowing the device to move more freely. If the initial sutures used to anchor the IPG fail or are not robust enough, the device can migrate. Direct trauma or impact to the implantation site, such as a fall or blow, can displace the battery.
Body changes, such as significant weight loss or gain, can alter tissue contours around the implanted device, potentially affecting its stability. Persistent muscle contractions or spasms near the IPG can gradually cause it to shift. Fluid collections, like a seroma or hematoma, around the device can also facilitate movement.
Identifying Battery Movement
Recognizing signs of spinal cord stimulator battery movement is important. An indicator is a visible change in skin contour, such as a new bulge or lump appearing away from the original implantation site. Patients might also experience localized pain, tenderness, or pressure at the new device location.
The displaced IPG could press against the skin, leading to irritation, redness, or thinning of the skin over the device. A key sign of potential battery or lead migration is a change in stimulation effectiveness. This manifests as decreased pain relief, altered sensation, or stimulation moving to an unintended area, often due to associated lead movement. Contact a healthcare provider if any of these changes are observed.
Addressing and Preventing Battery Displacement
When spinal cord stimulator battery movement is suspected, a healthcare provider conducts a physical examination and may order imaging tests, such as X-rays, to confirm its position. Once confirmed, addressing a displaced IPG requires a minor surgical procedure. This involves an incision to access the device, repositioning it into its intended pocket, and re-anchoring it with sutures. Manually pushing the device back into place is not a long-term solution.
Preventing battery displacement involves adhering to post-operative instructions. Patients are advised to limit strenuous activities, avoiding excessive bending, twisting, or lifting for a specified period after surgery, often several weeks. Wearing loose-fitting clothing around the implantation site can reduce friction and pressure on the device.
Maintaining a stable body weight and protecting the area from direct trauma are beneficial. Regular follow-up appointments allow for monitoring of the device’s position and function, helping to identify and address issues early.