A spinal cord stimulator (SCS) or dorsal root ganglion (DRG) stimulation device is used to manage chronic pain by sending electrical signals to the spine to reduce pain perception. The implantable pulse generator (IPG) is like the heart of this system, delivering these electrical impulses. The IPG is typically replaced when the battery reaches the end of its lifespan. Sometimes, due to issues like malfunction, infection, or discomfort (often felt as "pocket pain"), the IPG might need to be adjusted, fixed, or removed altogether.

This procedure accesses the IPG, typically placed under the skin in the lower back or buttocks. Under local or general anesthesia, a small incision allows for its relocation or removal. If malfunctioning or causing issues, removal may be necessary, with reimplantation if needed.

Patients typically undergo this procedure to manage conditions like nerve-related pain after back surgery, complex pain disorders (like complex regional pain syndrome or CRPS), or pain due to nerve damage, like in diabetic neuropathy. While this procedure helps restore or maintain the pain-relieving effects of the SCS/DRG system, it does come with some risks. These include the possibility of infection at the site, damage to the leads (wires) connected to the generator, and potential bleeding.

Preparation involves standard tests, including checking device settings and making sure no contraindicating conditions exist. It's important to reprogram or adjust the device post-procedure to ensure it's providing the best pain coverage. While other treatments, like oral medications or surgical pain pumps, are available, adjustments to the IPG can be vital for those who benefit from neuromodulation.

For recovery, patients generally follow light activity restrictions and avoid certain body movements to ensure proper healing, with monitoring to address any complications promptly. Overall, the goal is to achieve the best outcome in managing pain while minimizing discomfort and potential issues with the device.