Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Chronic Neuropathic Pain

Appropriate Follow-up

What is the appropriate number and timing of follow-up visits for SCS patients, and when is it appropriate to provide routine follow-up care for an SCS patient who was implanted elsewhere?

Follow-up visits should occur as often as necessary to ensure safe and effective operation of the stimulator.  Thus, the patient should have a postoperative surgical check and SCS adjustment, and on postoperative day 7 to 14, the patient should return for suture or staple removal and any needed additional adjustment.  From that point forward, monthly visits should gradually taper to yearly visits.

Elective follow-up of a new patient who was implanted elsewhere should adhere to the routine that applies to any new patient.  (For example, before an appointment is scheduled, the patient should provide sufficient information to allow the new physician to form an opinion about whether the patient could benefit from the physician’s help.)  As is standard in every field of medicine, a physician has the discretion to accept or reject any new patient.  In emergencies (for example, an obvious implant-related infection), however, the patient might require immediate treatment.

Strength of recommendation Evidence source(s)/rationale
A = Recommended or required
Valid, useful, or non-negotiable
  • Weighing risk versus potential benefit and expert consensus reveals a high likelihood of a favorable outcome