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Updated: Jun 7, 2026

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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Is Pocket Pain Still a Major Issue in Spinal Cord Stimulation?

Matthew W Scarsbrook1, Anneleigh Belle Twer1, Gage Tedford1

  • 1Department of Neurosurgery, University of Arizona College of Medicine, Tucson, AZ, USA.

Neuromodulation : Journal of the International Neuromodulation Society
|June 6, 2026
PubMed
Summary

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Pocket pain after spinal cord stimulation (SCS) has decreased due to thinner implantable pulse generators (IPGs). This trend reduces the need for revision surgeries, improving patient satisfaction with SCS therapy.

Area of Science:

  • Neurosurgery
  • Biomedical Engineering
  • Pain Management

Background:

  • Pocket pain is a common complication following spinal cord stimulation (SCS) surgery, often necessitating device revision or removal.
  • The development of smaller implantable pulse generators (IPGs) offered a potential solution to mitigate this issue.

Purpose of the Study:

  • To evaluate the trend in pocket pain incidence over time following SCS implantation.
  • To identify factors associated with the development of pocket pain and subsequent device revision.

Main Methods:

  • A longitudinal study analyzed 250 patients implanted with SCS devices between January 2017 and June 2025.
  • Data on patient demographics, implant characteristics (generator thickness, battery volume, pocket location), and clinical outcomes were collected.
Keywords:
Implantable pulse generatorSCS revisionspainpocket painpostoperativepostoperative complicationsspinal cord stimulation

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  • Pocket pain was identified through manual review of clinical notes, and statistical analyses were performed to assess correlations.

    • Main Results:

    • Pocket pain developed in 6.4% of patients, with 4.0% requiring revision or explantation.
    • A significant decrease in pocket pain incidence was observed annually (31% reduction in odds per year).
    • Thinner IPG generators and buttock pocket placement were associated with increased pocket pain, while generator volume was not a significant factor.

    Conclusions:

    • The incidence of clinically significant IPG pocket pain after SCS has declined.
    • Adoption of thinner IPG technology and refined implantation techniques have contributed to this reduction.
    • Ongoing advancements in SCS hardware and surgical practices are crucial for improving patient outcomes.