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Questions and Answers – Getting a Neurostimulator

Chronic Pain

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.

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Why do I need to take a 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.

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How long does the trial take?

The screening test period lasts approximately 3 to 7 days.

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Will it hurt?

You will have local anaesthesia 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 anaesthesia wears off. You should not have pain or discomfort during the rest of the trial period.

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Can I have pain medication during the 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.

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Will I receive the same relief that I get during the 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.

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After the 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, and for the surgery to be scheduled.

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Why would my doctor 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.

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What type of anaesthesia is used during the implant?

Typically, the implant of the neurostimulator is performed under general anaesthesia. However, you may wish to talk with your doctor about other options.

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What is the average length of the hospital stay?

Depending on your doctor's preference and hospital policy, a hospital stay may be recommended.

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How big are the incisions?

There are two incisions, both 2 to 4 inches long.

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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.

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Is spinal cord damage a possible complication?

In rare cases, spinal cord injury may occur from surgical placement of the lead.

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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.

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Between which vertebrae are the leads placed?

This depends on your specific condition and the results you received from the trial. Your doctor will advise you of the recommended location.

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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.

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Can the neurostimulator be removed?

Yes. The trial is designed to minimise 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 the system at any time.

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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

MR-Conditional Icon ** Under specific conditions and requires SureScan® MRI implantable neurostimulator and SureScan MRI leads

Next: Is A Drug Pump Right for You?

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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.