Boston Scientific Precision - Intraoperative Stimulation Testing

Precision™ Spinal Cord Stimulator System Clinician Manual
Clinician Manual
97035873-01 30 of 75
Intraoperative Stimulation Testing
Note: The following steps are for procedural reference only. Please refer to the BionicNavigator Software
Guide for detailed stimulation testing procedures and guidelines.
1. If using a splitter:
• Visually check splitter to leads connection
• Check impedance
Note: If using the 2x4 Splitter, make note of splitter conguration in the BionicNavigator™ software per
Splitter Programming Guide.
2. After linking the Clinician Programmer to the Trial Stimulator, check impedances to verify that components
are properly connected. Lead impedance is measured and displayed for each of the IPG’s 16 electrode
contacts. Impedances over 4500 Ohms are considered to be resultant from open or unconnected wires,
displayed with an X.
3. Using test stimulation, enlist patient feedback to verify lead placement and pain coverage.
Note: If lead repositioning is necessary, turn stimulation off before proceeding.
4. Reposition leads as necessary. If using a splitter, gently pull on lead attached to splitter to reposition
caudad or disconnect splitter from leads, re-insert stylet, and advance leads to reposition cephalad.
CAUTION: Do not force stylet into lead.
5. Steer lead to new position.
6. Remove stylet, wipe proximal ends of leads and reconnect splitter.
7. Check impedances.
8. Repeat steps 1-3 if lead has been repositioned.
9. When the desired paresthesia is achieved:
A. Turn the Trial Stimulator off.
B. Unlock each OR cable connector and disconnect from the lead(s).
C. For percutaneous lead(s) - slowly withdraw the stylet(s).
10. Record the lead position by capturing a uoroscopic image to be sure the leads have not moved. Retest
if necessary.
11. If using a splitter, disconnect splitter from leads. Insert the hex wrench and turn the set screw counter
clockwise to loosen.
Note: • The set screw should only be loosened to an amount sufcient to insert a lead.
• Do not excessively loosen the set screw. This may cause the set screw to dislodge, rendering the
splitter unusable.
Option A: For a Temporary Trial, proceed to “Securing the Trial Lead” on page 31.
Option B: For a Permanent Trial, proceed to “Permanent Lead Anchoring and Tunneling” on page 33.
Option C: For a Permanent IPG Implantation using percutaneous leads, proceed to “Permanent Lead
Anchoring and Tunneling” on page 33.
Option D: For a Permanent IPG Implantation using paddle leads, proceed to “Anchoring the Lead” on page
34.
Before receiving a permanent SCS system, it is recommended that patients undergo a trial procedure so that
they can experience stimulation to evaluate if SCS is effective at treating their chronic pain.