Intraoperative Stimulation Testing - Boston Scientific Precision Manuel

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 configuration 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 con-
nected. Lead impedance is measured and
displayed for each of the IPG's 16 elec-
trode 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 feed-
back 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 ad-
vance leads to reposition cephalad.
CAUTION: Do not force stylet into lead.

Intraoperative Stimulation Testing

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 with-
draw the stylet(s).
10. Record the lead position by capturing a
fluoroscopic 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 sufficient 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" page 27.
Option B: For a Permanent Trial, proceed to
"Permanent Lead Anchoring and Tunneling"
page 28.
Option C: For a Permanent IPG Implantation
using percutaneous leads, proceed to
"Permanent Lead Anchoring and Tunneling"
page 28.
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