Revision or removal of cranial neurostimulator pulse generator or receiver
CPT4 code
Name of the Procedure:
Revision or Removal of Cranial Neurostimulator Pulse Generator or Receiver
Summary
This procedure involves either adjusting (revision) or completely removing a device (pulse generator or receiver) that sends electrical impulses to the brain. The device is typically used to treat neurological conditions like chronic pain, movement disorders, or epilepsy.
Purpose
The purpose of this procedure is to ensure the neurostimulator is functioning correctly, relieve any complications such as infection or discomfort, or discontinue therapy if it's no longer needed or effective.
Indications
- Malfunction of the neurostimulator
- Infection at the site of implantation
- Pain or discomfort caused by the device
- Lack of therapeutic benefit
- Battery depletion
Preparation
- Fasting for several hours before the procedure
- Stopping certain medications as advised by the doctor
- Undergoing preoperative blood tests and imaging studies
Procedure Description
- Anesthesia is administered, usually general anesthesia.
- An incision is made near the implant site.
- The pulse generator or receiver is accessed.
- For a revision: Adjustments or replacements are made.
- For removal: The device is disconnected and extracted.
- The surgical site is carefully closed, and a sterile dressing is applied.
Duration
The procedure typically takes 1 to 3 hours, depending on the complexity.
Setting
The procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Neurosurgeon
- Anesthesiologist
- Operating room nurses
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Device malfunction or failure
- Nerve damage
- Anesthesia-related complications
- Possible headache or pain at the surgical site
Benefits
- Improved device function if revised
- Relief from any complications caused by the device
- Discontinuation of an unnecessary or ineffective therapy
Recovery
- Pain management with prescribed medications
- Instructions on wound care and activity limitations
- Follow-up appointments to monitor healing
- Recovery time varies but generally requires a few weeks for complete healing
Alternatives
- Medication therapy
- Different forms of neurostimulation
- Physical therapy
- Surgery to address underlying conditions without neurostimulation
Patient Experience
The patient might feel initial discomfort and pain after the procedure, manageable with pain medication. Some swelling and bruising around the incision site are normal. Follow-up care will involve monitoring for any signs of infection and ensuring proper healing. Most patients gradually return to their normal activities within a few weeks.