Spinal Cord Stimulator (SCS) Single Stage Implant – Going Home

Important information when going home

Introduction

Following your successful on table trial of SCS therapy you have now had the full system implanted. The information below tells you what to avoid, what to look out for and what action to take if you think that you have any problems.

Your SCS system will usually be left switched off after the full implant procedure to allow the wound over the implanted battery to heal. You will be given an appointment for the SCS clinic for approximately one week after the procedure for the therapy to be switched on.

Before going home with the spinal cord stimulator - assessment

Before you go home, the SCS team will make sure that your SCS system is working properly and providing stimulation to the area that was agreed. The team will also make sure you understand how to use the patient programmer and are confident to switch the device on and off, as well as change the strength of the stimulation, if the therapy has been switched on.

The team will look at your wound dressings and make sure that they are clean and not too painful. When you and the team are happy, you will be able to go home with follow-up appointment(s) arranged.

When you are at home

It is important to avoid certain movements and activities when you go home with the newly implanted SCS, so certain movements and lifting are to be avoided:

• Do not raise your arms above your head
• Do not twist, stretch or bend at the waist
• Do not lift heavy items, e.g. nothing above 5lbs/2.5kgs
• Avoid sitting for prolonged periods of time or driving
• Do not drive until you have your four week post implant follow up appointment and have been advised it is okay to do so

Stimulation changes

Stimulation may increase when you sit, lie down or bend slightly backwards. Stimulation may decrease when you stand and vary in intensity when you walk about.

We will remind you how to change the intensity feeling of the stimulation, using the patient programmer. If you are ever uncomfortable with the stimulation sensation remember you can always turn it off, using your patient programmer.

Complications

Infection, a blood clot and neurological damage from an implanted SCS system, are rare complications.

Because the electrode is placed close to the spinal cord, a collection of pus or a blood clot can cause pressure on the spinal cord. In the unlikely event of this, it is crucial to find and treat it as quickly as possible. This must be done by expert hospital doctors to prevent delays in treatment and long lasting damage.

Signs and symptoms to look out for:

• Fluid leaking from the spinal cord stimulator site
• Fluid leaking from the neurostimulator (internal battery) wound site
• Redness, pus, tenderness, or pain at the spinal cord stimulator or neurostimulator wound site
• Feeling generally unwell, despite there being no obvious reason
• High temperature or neck stiffness
• Numbness and/or weakness in your legs or arms,inability to weight bear
• Difficulty passing water /incontinence of faeces
• A headache that doesn’t improve with your usual treatment

What to do if you think there is a problem

If you experience any of the signs and symptoms listed above within the first 8 weeks following your SCS implant you should come to Addenbrooke’s hospital Emergency Department with this leaflet and your discharge summary. The on-call neurosurgical team will then be called to assess you and provide the necessary intervention and treatment.

If you are unsure you can contact the SCS nurses at the pain clinic Monday to Friday 08:30 to 16:00 on 01223 216993. Outside of these times you are advised to telephone 01223 216151 and ask for the on-call neurosurgical registrar.

Your SCS follow up appointment is on:

If you are having problems with your stimulation sensation please call the SCS nurses at the pain clinic on 01223 216993 and we will arrange the next available appointment for you to come in for a check up and re-programming session of your SCS.