IPG Site Creation, Considerations, and Risk Mitigation

Spinal cord stimulation serves as a reasonable neuromodulatory therapy for treatment of certain neuropathic pain presentations such as chronic postoperative spinal pain or complex regional pain syndrome. After experiencing widespread early adoption, the field of invasive neuromodulation has matured to include Consensus Committee guidelines and a larger evidence base that effectively function to standardize the practice of device implantation. In this chapter, we present an overview that spans from preoperative planning and device or battery pocket implantation strategy to postoperative complication management and risk reduction. The most common overall complication is surgical site pain, while the most common biological complication is superficial surgical site infection. Lead migration or fracture and pulse generator or battery failure are additional important complications. Lastly, we discuss considerations for reimplantation or revision.