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Desk work often possible after about 2 weeks; physical work takes longer."},"complication_rate_pct":{"min":15,"max":35,"unit":"percent","qualifier":"Any device-related complication (lead migration, infection, pain at pocket, hardware issues) within 1-2 years; serious ones under 5%."},"contraindications":["Active systemic or local infection at the planned implant site","Uncorrected bleeding disorder or unmanageable therapeutic anticoagulation","Failed trial stimulation (insufficient pain relief)","Untreated significant psychological conditions or substance use disorder","Pregnancy (relative, case-dependent)","Anatomy preventing safe lead placement, e.g., severe spinal stenosis (relative)"],"days_in_clinic":{"min":0,"max":1,"unit":"nights","qualifier":"Per procedure (trial or permanent percutaneous implant); usually same-day discharge, with an occasional overnight observation stay."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"From permanent implant; avoid strenuous activity, bending, twisting and heavy lifting while leads anchor. 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Pain relief may decline over time in some patients.","revision_rate_pct":{"min":10,"max":25,"unit":"percent","qualifier":"Surgical revision, repositioning or explant within 2 years, mainly for lead migration, hardware issues or infection."},"scars":"Small incision(s) at the lead entry site in the midline lower back and a pocket incision for the generator (buttock, flank or abdomen), typically a few centimetres each.","sessions_or_stages":{"sessions":{"min":2,"max":2,"unit":"visits","qualifier":"Two procedures: trial lead placement and permanent implant."},"stages":[{"code":"trial_lead_placement","label":"Trial: temporary percutaneous lead placement and external stimulation test","after":{"min":0,"max":0,"unit":"days","qualifier":"Initial procedure (day 0)."}},{"code":"permanent_implant","label":"Permanent percutaneous lead and implantable pulse generator placement after successful trial","after":{"min":7,"max":42,"unit":"days","qualifier":"From trial lead placement, after the trial period and review."}}],"qualifier":"Standard two-stage course (trial then permanent) with percutaneous leads; some centres implant permanent leads for the trial."},"success":{"metric":"Patients with at least 50% pain relief","value":50,"unit":"percent of implanted patients","horizon":"12 months after permanent implant","population":"Adults with chronic neuropathic back and leg pain and a successful trial","evidence_status":"limited"},"techniques":[{"name":"Percutaneous lead implantation with implantable pulse generator (primary approach)","suits_whom":"Most patients with a successful trial.","recovery":"Same-day discharge typical; return to light work in about 2-6 weeks."},{"name":"Surgical paddle-lead implantation (laminotomy)","suits_whom":"Patients with lead migration, failed percutaneous coverage or anatomy needing a paddle lead.","recovery":"Usually under general anesthesia; longer recovery, possible overnight stay."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":1,"max":2.5,"unit":"hours","qualifier":"For the permanent percutaneous lead and generator implantation procedure only; the trial lead placement is usually shorter."},"initial_assessment_documents":["Lumbar or cervical spine MRI report and images","Pain diagnosis and duration summary","Previous spine surgery operative reports","Pain treatments tried and outcomes","List of blood thinners"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Trial and implant 1-6 weeks apart; one trip needs 2-3 weeks' stay. Follow-up checks can be local."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask whether a trial of stimulation is done before the full system is implanted","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/spinal-cord-stimulator-implant/","host":"cuh.nhs.uk","quote":"Following your successful trial of spinal cord stimulator (SCS) therapy you have now had the full system implanted.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Ask whether a pain specialist and a spinal surgeon will both be involved in your care","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/spinal-cord-stimulation-scs-frequently-asked-questions-faq/","host":"cuh.nhs.uk","quote":"The procedure may involve both a pain specialist and a spinal surgeon.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Ask whether X-ray guidance will be used to position the 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some risks.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Confirm that follow-up appointments are arranged after implantation","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/spinal-cord-stimulator-scs-single-stage-implant-going-home/","host":"cuh.nhs.uk","quote":"When you and the team are happy, you will be able to go home with follow-up appointment(s) arranged.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-13","next_check_at":"2027-02-11"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Carry it at all times so staff know about the implant","document":"implant identification card","source":{"url":"https://www.cuh.nhs.uk/patient-information/spinal-cord-stimulation-scs-frequently-asked-questions-faq/","host":"cuh.nhs.uk","quote":"You should carry this with you at all times, especially when travelling.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"Lists warning signs and actions to take after the implant","document":"going-home information leaflet","source":{"url":"https://www.cuh.nhs.uk/patient-information/spinal-cord-stimulator-scs-single-stage-implant-going-home/","host":"cuh.nhs.uk","quote":"The information below tells you what to avoid, what to look out for and what action to take if you think that you have any problems.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T3","text":"Sets out safe activities and exercises during recovery after the implant","document":"physical activity advice leaflet","source":{"url":"https://www.cuh.nhs.uk/patient-information/cuh-spinal-cord-stimulator-scs-cervical-spine-physical-activity-advice/","host":"cuh.nhs.uk","quote":"The leaflet explains what activities are safe for you to do following your implant what to avoid while the wounds heal and which physiotherapy exercises can support your recovery.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T4","text":"Shows the scheduled review that the home doctor can follow up","document":"follow-up appointment 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