Perioperative Management of an Implanted Spinal Cord Stimulator: A Problem-Based Learning Discussion

Spinal cord stimulators (SCS) are increasingly implanted for chronic pain conditions, yet most anesthesiologists lack standardized training in their perioperative management. We present a case of a patient with an implanted SCS presenting for elective surgery, using this clinical scenario to address key decision points: preoperative device identification, electromagnetic interference from surgical energy sources, intraoperative monitoring considerations, and postoperative reactivation and analgesia. This report aims to equip clinicians with a practical framework for the perioperative care of patients with implanted neurostimulation devices.