Questions and Answers – Getting a Neurostimulator
How will my doctor know if I am a candidate for neurostimulation?
Talk with your doctor about your goals for treatment. Your doctor may do a screening test to see whether neurostimulation will provide adequate pain relief.
Why do I need to take a screening test?
Your participation in the screening test allows you and your doctor to evaluate whether you are a good candidate for neurostimulation treatment. The purpose of the screening test is to determine your response to neurostimulation, if it reduces your chronic pain, if it helps you meet your goals, and whether a neurostimulation system is the right pain treatment for you.
How long does the screening test take?
The screening test period lasts approximately 3 to 7 days.
Will it hurt?
You will have local anesthesia when the leads are placed. There may be some occasional discomfort during the procedure and you may have pain at the incision site once the anesthesia wears off. You should not have pain or discomfort during the rest of the screening test period.
Can I have pain medication during the screening test?
Your clinician may reduce or withdraw your oral medication 1 to 2 weeks prior to the test. During the screening test, oral medication may be given for breakthrough pain. Never stop taking your prescribed pain medication without first consulting your clinician.
Will I receive the same relief that I get during the screening test when I receive my permanent neurostimulator?
If the screening test has been successful and you go on to receive the permanent system, your pain relief may differ slightly. This is because the leads may be in a slightly different location than during the screening test. Be sure to tell your clinician about the way you feel so that changes can be made that will give you the best pain relief possible.
After the screening test, how long will it be until the neurostimulation system is implanted?
If you decide to proceed with neurostimulation therapy, in most cases there will be a waiting period after the screening test and before your implant procedure. This will give the area in your back where the leads were placed time to heal, for your insurance provider to be notified, and for the surgery to be scheduled.
Why would my doctor and I choose a neurostimulator that offers adaptive stimulation?
As you change positions, your spinal cord may move closer to or further from the electrodes that send out the mild electrical pulses. A therapy level that blocks your pain well when you’re standing may cause discomfort when you’re lying down.
Depending on the neurostimulator you and your doctor choose, you can either adjust the stimulation manually by using your programmer, or your neurostimulator will automatically adjust it for you when you change positions, using a technology called AdaptiveStim®. AdaptiveStim is available only from Medtronic, with the RestoreSensor® neurostimulator.
What type of anesthesia is used during the implant?
Typically, the implant of the neurostimulator is performed under general anesthesia. However, you may wish to talk with your doctor about other options.
What is the average length of the hospital stay?
Depending on your doctor's preference and hospital policy, a hospital stay may be recommended. However, the procedure may be performed on an outpatient basis, which means no overnight stay is required.
How big are the incisions?
There are two incisions, both 2 to 4 inches long.
Are there other side effects associated with placing the lead so near the spinal cord?
In rare cases, you may experience a "spinal headache." A spinal headache is caused when cerebrospinal fluid (the fluid that surrounds your spinal cord) leaks out from the intrathecal or epidural space. This headache may correct itself, or your doctor may treat it.
Is spinal cord damage a possible complication?
In rare cases, spinal cord injury may occur from surgical placement of the lead.
Can a previous abdominal incision be used?
No, because the incision needs to be made where the neurostimulator will be implanted to help properly anchor the device.
Between which vertebrae are the leads placed?
This depends on your specific condition and the results you received from the screening test. Your doctor will advise you of the recommended location.
Will I hear or feel the neurostimulation system inside me and will people notice it?
The neurostimulator does not make any noise. The device does not normally show through your clothes. It is usually implanted in the lower abdomen, where it is most comfortable and least visible. It may be felt as a small bulge under your skin.
Can the neurostimulator be removed?
Yes. The screening test is designed to minimize the possibility that neurostimulation will not help manage your pain. If you no longer need the neurostimulator or change your mind about the treatment, your doctor can turn off or surgically remove the system at any time.
Will my insurance company pay for a neurostimulator?
Many insurance carriers will pay for neurostimulation. However, as with many pain treatments, your doctor will have to get approval from your insurance company before you can receive treatment. Consult your doctor or insurance carrier for more specific information.
Is the procedure covered by Medicare?
Neurostimulators are approved for coverage by Medicare. Medicare will pay 80% of the cost as long as the procedure is determined to be medically necessary. Talk to your doctor about the Medicare Conditions of Coverage.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
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