You have been referred by your provider to Englewood Surgery Center for a surgical procedure. Below is a brief description on what you can expect before, during and after your procedure.

BEFORE SURGERY:
You will be scheduled for a “Pre-Op Physical” exam prior to your surgery.

Please bring an updated list of all your medications for the provider doing your physical exam and the nurse who will see you in ESC. Once the physical exam is completed, you will be given an order for blood work and escorted to the surgery center for an EKG.

• The nurse will review your health history and medications at the time of your EKG and discuss details of surgical day and post operative instructions.
• The anesthesiologist for your case may call you the night before surgery. If you do NOT receive a phone call, he will speak with you the morning of surgery to review your health history and answer any questions you may have.
• You will need to fast (NOTHING TO EAT OR DRINK) from 10pm the night before your surgery.

If you take medication for any health issues, please discuss this with your provider during your pre-op physical exam.

SURGERY DAY:

• Please leave all valuables at home.
• Dress in comfortable clothing that is loose fitting for ease after your procedure.
• Please refrain from using any fragranced lotion, perfume of cologne.
• You will need to arrive 1 hour prior to your surgery time. You must have a driver arranged to take you home. A family member or friend is welcome to accompany you and stay in the pre-op area until you are taken to surgery. The entrance to the surgery center is on the SOUTH side of ESC. If there is nobody in the lobby to greet you, please have a seat. We ask that you do not have small children in the pre-operative area.
• You will be asked to change into a gown and put on TED hose.
• An IV will be started by your pre-op nurse.
• Any consents necessary for your procedure will be reviewed and signed.
• The anesthesiologist, surgeon and physicians assistant will all be in to see you and answer any further questions you may have.
• Once you are taken to the OR on a stretcher, you will be hooked up to a blood pressure cuff, a heart monitor (3 sticky patches placed on your back) and a pulse oximetry finger probe.
• Once you are asleep, you will be moved to the OR table for surgery to begin.

AFTER SURGERY:

• Your family member or friend will be asked to wait in our lobby or the lobby for CCSI. One of the surgical nurses will keep them informed of the surgery start, mid-way through the procedure, and near the end of the case. The surgeon will meet with them briefly after the surgery.
• You will be transferred to the PACU area for recovery. Your family member or friend will be brought to the area once you are awake. They are welcome to stay in the PACU area or in the lobby.
• Recovery time with us varies from patient to patient. You will be discharged home once you have tolerated a snack and drink. We also need to be sure you are able to urinate before leaving. We will again review post op instructions with you and your family member/friend prior to discharge.

Purpose

The purpose of having a spine cord stimulator placed is to have the device transmit low level electrical signals that interfere with and keep pain signals from the legs or arms from being perceived in the brain. The stimulation substitutes the painful sensation with a mild tingling sensation that the patient can control with an external remote device. Patients who are candidates for this procedure have suffered from chronic pain and have not responded to other conservative measures such as anesthetic blocks or epidural steroid injections.

This procedure involves a trial period with a temporary stimulator that is connected to a small wire lead that is implanted beneath the skin and over the spinal cord. The stimulator is battery operated and sends out small pulses of electrical activity that interferes with the patient’s pain sensations. If this trial is successful, the patient will then be a candidate for the surgical implant, where the stimulator and battery are placed permanently under the skin.

What to expect

• Please arrive 60 minutes prior to your scheduled injection time. You will be asked to undress into a gown. The nurse will take a brief health history and have you sign paperwork necessary to proceed with the procedure. PLEASE BRING AN UP TO DATE MEDICATION LIST in order to expedite your check-in process.
• In consideration of other patients, please refrain from wearing perfume, cologne, or lotion.
• If you have a family member or friend with you, they are welcome to stay with you. Unfortunately, we do not allow small children in the pre or post op area.
• The doctor performing the injection will be in to discuss the procedure prior to your injection.
• You will be transported into the procedure room and positioned on the table. Your skin will be cleaned with sterile soap and draped in a sterile fashion. The skin over the target injection site will be anesthetized with a local anesthetic. Fluoroscopy is then used to guide the needle into the proper position. Medication is then slowly injected through the needle that has been placed.
• The procedure itself takes approximately 60 minutes and once completed, you will be transported back to the pre-op/recovery area.
• The nurse will take your vital signs and offer you a snack and drink. Your recovery time stay will be approximately 30 minutes.
• Post injection instructions will be reviewed and you will go home with a copy. We ask that you schedule your follow up appointment with your ordering provider in 10-14 days after the injection and bring your post injection pain scale to that appointment.

Risks

Every medical procedure, no matter how minor, contains some risks. Anytime a needle is placed into the body, there is a risk of tissue injury, infection and bleeding. If this occurs near the spine, it can result in nerve damage. Although extremely rare, nerve damage and death have occurred following spine injections. Injections near the spine also risk puncturing the dura and can result in headaches, which can easily be treated. More common risks include a temporary increase in pain, local tenderness after the injection, allergic reactions to the medications and side effects from the steroids.