A spinal cord stimulator (SCS) paddle lead revision, replacement, or removal is a surgical procedure aimed at addressing issues with previously implanted paddle leads, which are used to manage chronic pain. These paddle leads are placed near the spinal cord through a surgical procedure called a laminectomy or laminotomy, which involves removing a small part of the bone to access the spinal canal.

If the initial pain relief from the stimulator becomes insufficient, or if there's a hardware failure like lead migration or a malfunction, this procedure may be recommended.

During the removal procedure, you will be under general anesthesia for comfort. The surgeon makes an incision along your spine to access the leads. This can involve carefully removing scar tissue that has formed around the leads and may require additional bone removal for access. If removing the leads, a new set might be replaced in a better position to improve pain relief.

After the surgery, there are some important things to keep in mind. The patient will remain at the surgery center or hospital for a short period, as the procedure is typically performed as same-day surgery. Post-surgical instructions will include activity restrictions, such as avoiding heavy lifting (typically over 10 lbs), bending, or twisting, to minimize the risk of complications.

Bracing may be recommended to assist with recovery. It is strongly recommended to monitor the incision sites for signs of infection, such as redness or swelling. Full physical recovery can take up to six weeks.

While there are risks like infection, cerebrospinal fluid leaks, or potential nerve damage, these are rare. Alternatives to this procedure include less invasive percutaneous lead replacement or other neuromodulation therapies if suitable. Preparing for surgery involves preoperative imaging to evaluate the lead position and having medical evaluations to ensure you are fit for anesthesia.

Your provider will guide you on a detailed recovery path, ensuring your return to normal activities is smooth and safe.