Download a PDF of SCS and IDD Preop and Postop Instructions

 

Spinal Cord Stimulator Trial/Implant and Intrathecal Drug Delivery Pump Implant Instructions

We are delighted to provide you with excellent neuromodulation care. These procedures carry slightly greater postoperative pain and medical risks then typical injections or other procedures you may have had in the past. Please take the time to look through this instruction form to make sure we are fully prepared for pre-op care and post-op recovery.

If you have any additional questions, please call the office at 215-366-2803.

Pre-Procedure Instructions

  1. The most concerning risk of harm during the procedure involves infection. Please take the following precautions before the planned procedure to reduce the risk of infection:
    1. Address health-related factors that may impair your immune system. This includes:
      1. Cigarette/E-cig smoking (we can delay the procedure to try to quit smoking)
      2. Blood sugar management with diabetes (we will need an updated HgbA1C)
      3. Improving other medical conditions to make sure they are stable
    2. The night before the procedure, please wash your back with the chlorhexidine cleanser and clean your nose with Bactroban nasal swab.
    3. Make sure you receive prescribed antibiotics at the pharmacy before the procedure.
    4. Please call the office if you do not have the antibiotics, chlorhexidine wash or Bactroban.
  1. Home support: please identify family or friends to drive you to or from the procedure and will be available to assist you at home for first 2 days after the procedure.
    1. We recommend that you take off from work completely for 3-5 days. If your pain is well controlled, you may resume light duty work after if you can tolerate it. Many patients need several weeks off from work.

 

Post-Procedure Instructions

  1. Post-Op Pain: You should expect soreness and meaningful discomfort from the procedure site. This is worst the night after the procedure and the next day. The soreness should improve on day two or three after the procedure.
    1. For the first three days, use ice or a bag of frozen peas for 20 minutes on and 20 minutes off. Do not directly apply ice to the skin or bandages (use a towel or cloth).
    2. Take over the counter Tylenol 500mg to treat pain. If you still have pain, you may next take a prescribed pain medication.
      1. Avoid aspirin that may increase bleeding
    3. Severe 9-10 /10 pain after the procedure is not normal. Call us immediately if you have severe pain that feel is an emergency or not controlled with medications.
  1. Infection Control: Call us immediately if you notice pus formation from the wound, experience fevers or chills, nausea/vomiting, mental status changes or other signs of severe illness.
    1. Take the prescribed antibiotics starting the night after the procedure
  1. Wound Care: Call us immediately if you notice complete saturation of blood on your dressings. Some blood is expected and normal in the gauze, but it should not be completely soaked.
    1. Trial Instructions: Try to keep dressings and tape in place during the entire duration of the trial.
      1. Do not get the dressings wet. You may use a handheld shower or sponge bathe.
      2. If the tape or gauze falls off, please replace it with the medical supplies provided.
    2. Implant Instructions: Keep the dressings on and dry for 48 hours. You may remove the tape, tegederm (clear plastic bandage) and gauze after 48 hours in order to shower. Keep the steri-strips in place (do not remove). It is okay if they fall off on their own.
      1. After removing surgical dressings, you may allow it to air out for a couple hours in a clean environment. You may re-dress with a clean set of gauze and tape over the wound for another 24-48 hours.
        1. Make sure to wash your hands whenever handling the wound and to be in a clean environment.
      2. KEEP THE WOUND CLEAN AND DRY. It is okay to gently pat dry with a towel.
  1. Physical Restrictions: Excessive physical activity may cause a migration of the device or disturb wound healing. Please use caution during the entire duration of the trial and 2 weeks after the implant.
    1. Please restrict the B-L-Ts. Keep to a minimum Bending, Lifting and Twisting.
      1. Do not stretch, twist or bend your body at the waist or neck. For example, try to log roll out of bed, bend with your knees and avoid making quick and sudden movements.
      2. Do not lift anything heavier than a half-gallon of milk (5 pounds).
    2. For two weeks or during the trial:
      1. Avoid lifting arms above your head.
      2. Avoid long car rides that are not necessary.
  • Limit walking up stairs.
  1. After two weeks you may resume light activities. For example, you may go for brief walks on flat ground. Avoid excessive physical exertion (high intensity exercise, labor intensive work) for 6 weeks.
  2. Do not fully submerge in water (such as swimming pool or bathtub) for 6 weeks.
  3. Please use the back brace or neck collar if one was provided to you.
  1. Call us Immediately if:
    1. You have a fever greater than 101 degrees or you feel you are sick.
    2. You notice the dressings become saturated with blood or pus.
    3. You notice severe redness or swelling at the surgical site.
    4. You experience severe pain that cannot be controlled with prescribed medications.
    5. You experience numbness in your legs, weakness, experience and falls or loose bladder/bowel control.

If you have any additional questions, please call the office at 215-366-2803.