Name of the Procedure:

Receiver and/or transmitter, neurostimulator (implantable)
Common Names: Neurostimulator implant
Technical Terms: Implantable Neurostimulator, C1816

Summary

An implantable neurostimulator is a device surgically placed under the skin that sends electrical impulses to specific areas of the body. These impulses help manage chronic pain or other neurological conditions by altering nerve activity.

Purpose

Conditions Addressed: Chronic pain, Parkinson’s disease, epilepsy, and other neurological disorders.
Goals/Outcomes: The main goal is to reduce pain, improve quality of life, and enhance the functional abilities of patients.

Indications

Symptoms/Conditions: Severe, chronic pain not responsive to other treatments, tremors, seizures, muscle spasticity.
Patient Criteria: Patients who have not found relief through medications or less invasive treatments and have undergone psychological and physical evaluations to determine suitability.

Preparation

Instructions: Patients may be advised to fast for a certain period before the procedure and adjust medications as directed by their healthcare provider.
Diagnostic Tests: Imaging scans, blood tests, and a full physical examination may be required to ensure the patient is a good candidate for the implant.

Procedure Description

1. Anesthesia: Administered general or local anesthesia based on individual cases.
2. Incision: A small incision is made near the targeted nerve area.
3. Device Placement: The neurostimulator is implanted under the skin.
4. Lead Placement: Electrodes (leads) are positioned near the nerves or spinal cord.
5. Testing: The device's settings are tested to ensure effective stimulation.
6. Closing: Incisions are closed and the area is dressed.

Tools/Equipment: Neurostimulator device, electrodes, surgical instruments.
Anesthesia/Sedation: Generally local or general anesthesia based on patient and procedure specifics.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Performed in a hospital or surgical center, often with a short stay or same-day discharge.

Personnel

Involved Professionals: Neurosurgeon or pain management specialist, anesthesiologist, surgical nurses, and technical staff for device programming.

Risks and Complications

Common Risks: Infection, bleeding, pain at the incision site.
Rare Risks: Device malfunction, nerve damage, allergic reactions to the device materials.
Management: Follow-up appointments, antibiotics for infections, device reprogramming if malfunctioning.

Benefits

Expected Benefits: Reduction in pain, decreased need for pain medication, improved mobility and quality of life.
Timeline: Benefits can often be observed within weeks, though full adjustment may take a few months.

Recovery

Post-Procedure Care: Instructions on wound care, activity restrictions, and medication usage.
Recovery Time: Generally a few weeks, with follow-up visits to adjust device settings and monitor recovery.

Alternatives

Treatment Options: Physical therapy, medications, non-implantable external neurostimulators, nerve blocks.
Pros and Cons: Alternatives may be less invasive but might not provide the same level of relief or have lasting effects.

Patient Experience

During Procedure: Little to no pain due to anesthesia.
After Procedure: Some discomfort at the incision site, manageable with prescribed pain relief. Most patients can resume daily activities shortly after recovery, with periodic adjustments to the device settings for optimal comfort and efficacy.