Boston Scientific Precision Spinal Cord Stimulator System, Clinical Manual

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Permanent Lead Anchoring and Tunneling
Clinician Manual
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Permanent Lead
Anchoring and Tunneling
Removing the Insertion Needle
1. Cut down around the insertion needle to
provide access for anchoring the lead.
2. Carefully withdraw the insertion needle
from the epidural space by slowly pulling
the needle up towards the proximal end of
the lead while holding the lead in place.
3. Once the insertion needle tip is exposed,
hold the lead as close to the exit site as
possible, then carefully pull the needle
completely from the lead.
Anchoring the Lead
Leads can be permanently anchored with a
suture sleeve or with a Clik™ Anchor. Refer
to the Clik Anchor Directions for Use, or
continue with the following steps to anchor
using a suture sleeve .
1. For percutaneous leads, carefully remove
the lead stylet using fluoroscopy to ensure
the lead position does not change.
2. Place a suture sleeve over the lead and
down to the supraspinous ligament or
deep fascial tissue.
3. Ligate the suture sleeve onto the lead by
tying a 2-0 silk or other nonabsorbable
suture around the center groove of the
sleeve to prevent sliding. Circumferential
stitches may be tied at the compression
slots.
CAUTION: Do not use polypropylene
sutures as they may damage the
suture sleeve. Do not suture directly
onto the lead or use a hemostat on the
lead body. This may damage the lead
insulation.
Note: The 4 cm and 2.3 cm suture sleeves
each have three (3) compression
slots, which are designed to reduce
slippage.
4. Suture the sleeve to the supraspinous
ligament or deep fascia through the
suture sleeve holes.
5. Tie multiple sutures as tightly as possible
around the suture sleeve to secure it to
the lead.
CAUTION: Tightening sutures directly
on the lead can damage the lead.
6. For Permanent Trials, proceed to the
instructions for “Tunneling the Lead or
Lead Extension” page 29.
7. For Permanent IPG Implantation, proceed
to the instructions for “IPG Implantation”
page 34.