Spinal cord stimulators (SCS) treat chronic pain when other therapies have failed. Patients considering this intervention often want to understand the procedure’s timeline. This article clarifies the typical duration and aspects of spinal cord stimulator surgery.
Duration of the Surgical Procedure
The permanent implantation of a spinal cord stimulator typically takes one to three hours. This timeframe covers operating room activities, including lead and neurostimulator device placement. The procedure is often outpatient, allowing patients to return home the same day after anesthesia recovery. This surgical time does not include the total duration at the hospital or surgical center, which also accounts for pre-operative preparation and post-operative monitoring.
Steps Involved in the Surgery
Permanent SCS implantation involves several stages. Patient preparation includes local anesthesia and often a mild sedative. The surgeon makes an incision, typically in the lower back, to access the epidural space near the spinal cord. Through this incision, thin, flexible wires called leads are carefully guided into place.
Once leads are positioned, a second incision is made, usually in the abdomen or upper buttocks, where the implantable pulse generator (IPG) or battery is placed under the skin. The leads connect to this generator, establishing the complete system. Both incisions are then closed with sutures and covered with dressings. Patients move to a recovery area to awaken from anesthesia before discharge.
Factors Affecting Surgical Time
Several elements can influence SCS surgery duration. Patient anatomy complexity, such as scar tissue from previous surgeries, can affect lead placement time. The number of leads implanted also plays a role; more leads may necessitate additional time for precise positioning. Surgeon experience and the specific SCS system type can also impact the surgical timeline. Unforeseen complications during the procedure, such as lead migration or device placement issues, would also extend surgical time.
Understanding the Spinal Cord Stimulator Trial
Before permanent SCS implantation, patients typically undergo a temporary trial. This trial is a separate, less invasive outpatient procedure, usually lasting 30 to 90 minutes. During the trial, temporary leads are placed near the spinal cord, similar to the permanent procedure, but connect to an external battery pack worn by the patient.
The trial, which typically lasts three to seven days, assesses how well spinal cord stimulation reduces pain. Patients are encouraged to engage in usual daily activities while keeping a pain log. A successful trial, often defined as a 50% or greater pain reduction, helps determine if a permanent implant is a suitable long-term solution.