Infection: every trial and every implantation of a system carries a risk of infection of around 2%. Usually infections mean that the trial leads or implanted system must be removed (explanted) in theatre and a course of antibiotics must be taken. The treating team take the risk of infection very seriously and follow many precautions trying to prevent it. It is important that patients are also mindful of the risk and follow advice. After time for infection to fully disappear, replacing SCS can be considered again.
Pain: Placing leads and an IPG (battery) into the body is a minor surgical procedure. Localised pain will be felt from this until the sites heal. Persisting pain after healing can occur because of the physical presence of the leads, lead anchors, or, more commonly, the IPG (battery) in the body.
Bleeding: Placing leads and an IPG (battery) into the body is a minor surgical procedure and bleeding can be a complication. This is much more likely if people are taking blood thinning drugs so it is very important that patients discuss these medications with their treating team so they can be stopped before surgery at the right time. Minor bruising is common. Bleeding that requires return to surgery happens in around 1% of cases.
Nerve Damage: Spinal cord stimulation leads are sited very careful and gently by experts while using x-ray image guidance. The incidence of new permanent nerve damage is very low – estimated to be 1 in 2000?
Paralysis: This is very rare indeed. When cases have been described, it is not due to the stimulation itself. It has been due to bleeding, or infection, or surgical complications in difficult cases.
SCS lead problems: Sometimes leads can move position or stop delivering the electrical pulses properly. If this causes in a loss of benefit from spinal cord stimulation. A “revision” procedure may be required to reposition and/or replace leads.
IPG (battery) problems: Sometimes people have pain at the IPG (battery) site. Sometimes the IPG position moves a little over time. Significant weight loss or weight gain can cause problems with an existing IPG position. Occasionally, an IPG develops technical problems. These problems might result in a “revision” procedure to resite the IPG. Usually, an IPG battery is expected to last about 8 to 10 years, but sometimes it goes flat much earlier due to unexpected levels of use, and requires earlier replacement or consideration of alternatives.
Failure of therapy: Some people do not benefit from spinal cord stimulation from the outset. These people are non-responders to the trial of therapy. Some people report good benefit in the trial, and have an SCS system implanted, but later on they report their pain is no longer responding even when the system is still working well.