Doctor Discussion Guide
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Have questions? We’ll try to help give you answers. Below, you’ll find answers to common questions about Medtronic spinal cord stimulation (also known as neurostimulation therapy). Don’t see your question here? Ask your doctor, or find a specialist near you who can answer your questions.
Talk to your doctor to determine the kinds of pain treatments that may work for you. The choice of treatment depends on the type of pain, its severity, and your response to your pain treatment. If your doctor thinks you are a good candidate for spinal cord stimulation, you can complete a screening test to see if it will provide adequate pain relief.
You may feel a sensation from spinal cord stimulation, depending on your stimulation level. Your stimulation level can be adjusted to deliver your preferred sensation and pain relief.
Typically, people who find the treatment helpful experience significant and sustained reduction in chronic pain.1 However, spinal cord stimulation does not eliminate the source of pain, so the amount of pain reduction varies from person to person. Neurostimulation therapy is not a cure for chronic pain, but rather a therapy to help you manage your pain.
As you change positions, your spinal cord may move closer to or farther from the electrodes that send out the mild electrical pulses. A stimulation level that manages 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, using AdaptiveStim® Technology. Adaptive stimulation is available only from Medtronic with the RestoreSensor® implantable neurostimulator. Adaptive stimulation reduces the need to manually adjust your stimulation level when you change positions.
Your spinal cord stimulation system will not provide relief from other types of pain such as headaches, stomachaches, fractures, etc.
No. Spinal cord stimulation was approved by the U.S. Food and Drug Administration in 1984.
Many insurance companies 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. Your out-of-pocket costs will vary according to your insurance plan. Consult your doctor or insurance carrier for more specific information.
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.
The procedure to get the screening test takes approximately 30 to 90 minutes. The screening test period lasts approximately 3 to 7 days.
You will have local anesthesia when the leads (thin, insulated medical wires) 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. This should resolve after a day or so.
Complications can occur with the screening test and may include infection and movement of the lead within the epidural space. Please discuss the benefits and risks with your doctor.
Your doctor may reduce your dose or have you stop taking oral medication 1 to 2 weeks prior to the test. During the neurostimulation screening test, oral medication may be given for breakthrough pain. Never stop taking your prescribed pain medication without first consulting your doctor.
Your pain relief may differ slightly. For most people, the stimulation they feel after implant is similar to that at the screening test. Your doctor can adjust your neurostimulator so it delivers the best pain relief possible. Be sure to tell your doctor about the way you feel, so changes can be made to optimize your therapy.
If the screening test is successful, you and your doctor will discuss when the system should be implanted. There is typically a waiting period between the screening test and the implant procedure. This will give the incision in your back time to heal and allow time for your insurance provider to be notified and for the surgery to be scheduled.
Many people experience improvements in their pain symptoms and quality of life after receiving Medtronic spinal cord stimulation. Benefits may include:
In addition, this treatment:
The neurostimulation implant is placed under the skin surgically. So, surgical complications are possible, similar to other surgeries. These may include infection, pain at the site of surgery, and bleeding into the epidural space.
Once the neurostimulation system is implanted, it’s possible that device complications may occur. These include corrective surgery, jolting, lead breaking, and movement of the lead within the epidural space, which may require reprogramming or surgical replacement of the leads. These events may result in uncomfortable stimulation or loss of therapy.
See Important Safety Information for more details. Also, please discuss the benefits and risks of this therapy with your doctor.
The procedure to implant the neurostimulation system takes approximately 1 to 3 hours and may require a brief hospital stay.
Typically, the implant of the neurostimulation system is performed under general anesthesia. However, you may wish to talk with your doctor about other options.
Depending on your doctor’s preference and hospital policy, an overnight hospital stay may be recommended. However, the procedure may be performed on an outpatient basis, which means no overnight stay is required.
The device is about the size of a stopwatch.
The spinal cord stimulator does not make any noise. The device does not normally show through your clothes. It is often implanted in the lower abdomen, where it is most comfortable and least visible. It may be felt as a small bulge under your skin.
You control the spinal cord stimulation with a handheld programmer that works like a remote control to adjust your stimulation within the settings your doctor has selected. With AdaptiveStim Technology, you can be active without having to adjust your stimulation setting—it automatically adjusts it for you.
A typical follow-up schedule is once every 6 months, although initially the neurostimulation system may require more frequent adjustments to provide the best pain relief possible.
Yes, it can be turned off or surgically removed, if desired.
When you have an implanted electronic device, you have to be careful about MRI scans. Medtronic spinal cord stimulation systems with SureScan® MRI Technology are the only systems of their kind to relieve pain and allow safe* access to an MRI scan on any part of the body. If your doctor prescribes a Medtronic system that does not have SureScan MRI Technology, you will have access to MRI head scans.**
* Under specific conditions; requires SureScan MRI implantable neurostimulator and Vectris® SureScan MRI leads.
**Excludes Itrel® 3