A spinal cord stimulator (SCS) is an implanted medical device designed to manage chronic pain by delivering mild electrical impulses directly to the spinal cord. This neuromodulation device alters pain signals before they reach the brain, providing relief for individuals whose pain has not responded to other treatments. While an SCS can improve quality of life, users must be aware of its limitations and precautions. Adhering to these guidelines ensures patient safety and long-term system functionality.
Medical Procedures to Avoid
Individuals with an SCS must exercise caution with certain medical procedures due to potential risks. Magnetic Resonance Imaging (MRI) is a concern because strong magnetic fields can cause heating around the device, device damage, or patient injury. Many modern SCS devices are “MRI Conditional,” allowing safe MRI scans under manufacturer-specified conditions, such as using an “MRI Mode” or turning off stimulation. Older or “MRI Unsafe” devices prohibit MRI scans entirely. Always inform healthcare providers about the SCS before any imaging or procedure.
Other procedures also pose risks. Diathermy, which uses high-frequency currents to generate heat, is contraindicated as energy can transfer through the SCS system, potentially causing tissue damage. Electrocautery, used to stop bleeding during surgery, can interfere with the SCS, making bipolar electrocautery preferable to monopolar, and requiring the SCS to be turned off.
External defibrillation, which delivers an electrical shock, can damage the SCS system or induce currents, so the stimulator should be turned off if it does not delay emergency treatment. Lithotripsy, using high-output sound waves for kidney stones, can damage the implanted pulse generator if the energy is focused near it. Radiation therapy carries a risk of damaging the SCS’s electronic circuitry, similar to cardiac pacemakers.
Restrictions on Physical Movement
After SCS implantation, physical movement restrictions ensure proper healing and prevent complications. During the initial weeks to months, avoid sudden, twisting, stretching, or jarring movements. This precaution helps prevent lead migration or breakage. Lead migration can cause loss of stimulation or uncomfortable stimulation, potentially requiring surgical intervention.
Activities involving heavy lifting, excessive bending, twisting, or reaching overhead can place undue stress on the implanted system. Engaging in high-impact sports or activities that could result in direct trauma to the implant site also carries a risk of damaging the device components. These movements and impacts can compromise the integrity of the leads or the pulse generator, potentially leading to device malfunction or reduced effectiveness. Adhering to these physical limitations ensures the SCS’s long-term stability and functionality.
Interference with Devices and Equipment
Individuals with an SCS should be aware of potential interference from external electrical or magnetic fields, which can affect the device’s operation. Strong magnetic fields, such as those generated by industrial equipment, powerful speakers, or large motors, can temporarily or permanently alter the SCS settings or even turn the device off. Electronic devices also warrant attention; for instance, cell phones should be kept a safe distance from the implant site to avoid interference.
When encountering security checkpoints, such as airport metal detectors or anti-theft devices, inform security personnel about the implanted device. These systems can cause temporary changes in stimulation or trigger alarms. Users might experience unexpected changes in stimulation, buzzing sensations, or discomfort if interference occurs. Carrying the SCS identification card is important in these situations, as it provides quick verification of the implanted device, facilitating smoother passage through security protocols.
Considerations for Daily Activities
Navigating daily life with a spinal cord stimulator involves practical considerations and minor modifications to ensure safety and device longevity. When driving, individuals should be mindful that sudden changes in stimulation intensity could potentially cause muscle spasms or distraction. It is often recommended to turn off the stimulation while operating a motor vehicle or heavy machinery to prevent such occurrences. Patients should follow their doctor’s specific recommendations and be aware of any local regulations concerning driving with an SCS.
While many contemporary SCS devices are designed to be water-resistant, precautions are still advisable for activities like bathing, using hot tubs, or swimming. Ensuring that incision sites are fully healed before submersion is crucial to prevent infection. Regarding work and hobbies, individuals whose activities involve heavy machinery, strong electrical fields, or significant physical exertion should consult their physician. This allows for an assessment of potential risks and necessary adjustments to protect the device. When traveling, particularly internationally, carrying the SCS identification card is important, as it provides essential information about the device to medical and security personnel, and helps in understanding different electrical standards or accessing medical care if needed.