Advanced Therapy for Chronic Pain Relief: Neurostimulation

Discussion

What brings you here today? What is neurostimulation? How can you know that it will

help your pain? What are the next steps?

What Has Been Your Success with These Therapies?

TENS NSAIDs

Ibuprofen and Aspirin Pain Medications Biofeedback OTC Pain Rehabilitative Therapy Systemic Opioids

Morphine Nerve Blocks

How Would You Like Your Life to Improve?

What activities do you want to be able to do ?

How would you like your life to change?

"Without this therapy, I would be in a wheelchair.

Instead, I'm fishing with my family.” -Luella Thomas*, patient and ANS Ambassador

*The above testimonial is the experience of this individual only. It is an individual result and we do not claim that it is representative of the experience that all or most patients achieve and is not indicative of future performance or success .

Your Physician Has Recommended Neurostimulation

Most likely because You have had pain that has

lasted more than 4-6 months You have had limited pain

relief from your current pain medications or pain therapies

You have had multiple procedures that have not worked

What Is Neurostimulation? Neurostimulation is also commonly

known as spinal cord stimulation (SCS) A non-drug pain relief therapy that

works by generating mild electrical pulses and sending them along your spinal cord to the brain

It replaces the feeling of pain with a tingling or massaging sensation

Established Therapy for Chronic Pain

Neurostimulation is a widely accepted medical treatment.

Similar technology to pacemakers.

Each year as many as 50,000 neurostimulators are implanted worldwide.1

1Simpson BA. Electrical Stimulation and the Relief of Pain. Boston, Mass: Elsevier; 2003. Pain Research and Clinical Management, Vol. 15.

Established Therapy for Chronic Pain

FDA-approved therapy for treatment of chronic pain of the trunk and limbs

Covered by most major health insurance plans, Medicare and worker’s compensation programs

A Study of Chronic Pain Sufferers Who Used ANS Neurostimulators¹

84% reported that their quality of life was improved or greatly improved

77% had good or excellent pain relief 82% decreased their use of pain

medications

¹ Advanced Neuromodulation Systems. Prospective, Multi-Centered, Single Arm Study to Evaluate the Safety and Effectiveness of Genesis™ Implantable Pulse Generator in Combination with ANS Percutaneous Leads for the Management of Chronic Pain of the Trunk and/or Limbs. Plano, Tex; 2006.

“I felt my little toes for the first time in years, and I started crying. It was the most wonderful

sensation I’d ever felt.”

-Deborah Sanders*, patient since 2006 and ANS Ambassador

*The above testimonial is the experience of this individual only. It is an individual result and we do not claim that it is representative of the experience that all or most patients achieve and is not indicative of future performance or success .

How will I Know if This Therapy will Reduce My Pain?

A “trial period” allows the patient to evaluate the effect of pain relief before deciding on this therapy in the long term

The Trial (Screening) Period

Has a unique advantage over other pain management therapies in that it can be removed at any time

Typically 5-7 days

What Can I Expect During a Trial?

A minimally invasive outpatient procedure

Similar to an epidural steroid injection

One or more leads are placed in the space along the spinal cord

What Can I Expect During a Trial?

Patient is generally awake during the procedure so that they can provide feedback to the physician regarding exact placement.

What Can I Expect During a Trial?

The lead or leads connect to a system that can be worn on a belt. The system may contain a variety of programs to allow the patient to best evaluate the stimulation.

What Are The Elements of a Successful Trial?

Your pain is reduced to a manageable level so that you may return to a more normal lifestyle

Many people consider spinal cord stimulation successful if: It is easier for them to go places and do

things It helps them sleep better It reduces their need for drugs

If the Trial is Successful, What Happens Next ?

You may wish to discuss delivery of this therapy with your physician

Discuss what type of system is best for your pain needs and lifestyle

Implanted device may be performed as an outpatient procedure

Although called permanent, still reversible

Patient Ambassador Program

Opportunity to connect with real patients who have ANS devices

Candidate can email or phone

Patient ambassadors are volunteers

“In a heartbeat. I highly recommend it.” “It’s something everybody can understand. It’s easier

to use than a remote control on a TV.”

-Ralph Wright*, patient and ANS Ambassador

*The above testimonial is the experience of this individual only. It is an individual result and we do not claim that it is representative of the experience that all or most patients achieve and is not indicative of future performance or success.

More Information

Talk to your ANS clinical representative

Go to PowerOverYourPain.com for more information

Contact a Patient Ambassador

Check your insurance coverage

Eon® and Genesis® SystemsIndicated Use Statement

“Aid in the management of chronic intractable pain of the trunk and/or limbs including unilateral or bilateral pain associated with any of the following: failed back surgery syndrome, and intractable low back and leg pain.”

Renew® RF SystemIndicated Use Statement

“Indicated for spinal cord stimulation in the treatment of chronic pain of the trunk and limbs either as a sole mitigating agent or as an adjunct to other modes of therapy used in a multidisciplinary approach .”

Product Safety Information Indications for Use: Chronic, intractable pain of the trunk and

limbs. Contraindications: Demand-type cardiac pacemakers, patients

who are unable to operate the system or who fail to receive effective pain relief during trial stimulation.

Warnings/Precautions: Diathermy therapy, cardioverter defibrillators, magnetic resonance imaging (MRI), explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, postural changes, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.

Adverse Events: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis).

User’s guide must be reviewed prior to use for detailed disclosure.

Caution: U.S. federal law restricts this device to sale and use by or on the order of a physician.

Questions?

Additional Information Regarding Neurostimulation

Components of a Trial System

Trial Lead

Trial Cable

Trial Transmitt

er

What is My Role During a Trial Screening?

Understand and comply with movement restrictions

Understand what sensations to expect

What Is My Role During a Trial Screening?

Document your response to treatment, pain level and functional changes (trial diary will be provided)

Follow physician’s recommendations on activity level

During the Trial: Do’s Follow you physician’s orders

regarding activities and wound care

Sleep on your back or side Keep your incision dry by taking

sponge baths Keep a trial diary Call your physician immediately

if you notice any signs of infection such as Fever Chills Redness Increased pain at the incision

site

During the Trial: Don’ts Pull on the trial cable or lead Disconnect the trial cable from the lead Operate vehicles, machinery, or power

equipment with the stimulator on Reach, bend, or stretch Lift more than five (5) pounds Climb many stairs Sleep on your stomach Engage in strenuous activity during the trial

Implanted device

Generator and leads placed within body

Procedure time may be similar to a trial procedure

Often performed on an outpatient basis or in a surgery center

Reversible

What are the Components of a Neurostimulator?

Programmer "Remote control” that lets

you adjust the strength and/or location of stimulation

Generator Holds the electronic

components and sends the electrical current through the lead

Leads Very thin cables that deliver

electrical pulses to nerves along your spinal cord

Eon® and Genesis® SystemsIndicated Use Statement

“Aid in the management of chronic intractable pain of the trunk and/or limbs including unilateral or bilateral pain associated with any of the following: failed back surgery syndrome, and intractable low back and leg pain.”

Renew® RF SystemIndicated Use Statement

“Indicated for spinal cord stimulation in the treatment of chronic pain of the trunk and limbs either as a sole mitigating agent or as an adjunct to other modes of therapy used in a multidisciplinary approach .”

Product Safety Information Indications for Use: Chronic, intractable pain of the trunk and

limbs. Contraindications: Demand-type cardiac pacemakers, patients

who are unable to operate the system or who fail to receive effective pain relief during trial stimulation.

Warnings/Precautions: Diathermy therapy, cardioverter defibrillators, magnetic resonance imaging (MRI), explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, postural changes, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.

Adverse Events: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis).

User’s guide must be reviewed prior to use for detailed disclosure.

Caution: U.S. federal law restricts this device to sale and use by or on the order of a physician.

Thank you for your time!