Questions and Answers – Getting a Neurostimulator
How will my doctor know if I am a candidate for spinal cord stimulation?
Talk with your doctor about your goals for treatment. If your doctor thinks you are a good candidate for spinal cord stimulation, you can complete a screening test to see whether spinal cord stimulation will provide adequate pain relief.
Why do I need to take a screening trial?
Your participation in the trial allows you and your doctor to evaluate whether you are a good candidate for spinal cord stimulation. The purpose of the trial 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 trial 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 trial period.
Can I have pain medication during the screening trial?
Your clinician may reduce or withdraw your oral medication 1 to 2 weeks prior to the trial. During the trial, 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 trial when I receive my permanent neurostimulator?
If the trial 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 trial. 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 trial, how long will it be until the neurostimulation system is implanted?
If you decide to proceed with spinal cord stimulation, in most cases there will be a waiting period after the trial 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 pain may change. As a result of these changes in pain, your neurostimulation system may have to be adjusted to provide continued comfort.
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 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 or upper buttock, 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 spinal cord stimulation. 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.
What if I need an MRI?
When you have an implanted electronic device, you have to be careful about MRI scans. The good news is that MRI scans are possible with Medtronic neurostimulation systems for chronic pain,* with proper safeguards. In fact, only Medtronic offers neurostimulation systems that allow safe** access to MRI scans anywhere in the body, under specific conditions.
* Excludes Itrel® 3
** Under specific conditions and requires SureScan® MRI implantable neurostimulator and Vectris® SureScan MRI leads
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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