What's inside an implantable Medtronics Itrel 3 Neurostimulator designed for Neuropathic pain reduction.
Dave tears into the ultrasonically welded titanium case.
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Hi I've got a very interesting teardown for you today. Let's check it out. This one's actually a very old mailbag item. Thank you very much man who for sending this in a long time ago in a mailbag galaxy far far away and sorry I Haven't gotten around to doing this now.

A lot of people are familiar with a product that looks something like this. You might think that this is actually an implantable pacemaker, but it's actually not quite that. It is different. It's a neuro stimulator designed to send impulses into the nervous system.

Yes, it is an implantable device and it's designed to treat neuropathic pain. And you know, like a presumably very chronic because I get in one of these installed implant is into you is not a trivial thing, it's so yeah. you'd want to have like a real chronic case of neuropathic pain - actually. I Go to this effort because you know the first step is drugs and other you know, opioids and other things to treat the pain.

And yes, this one here is actually an X implanted device. And yes, it's okay. it has been properly sterilized and everything else. so this used to be inside somebody's body.

sorry I don't have the details if you know the serial number play along at home. is that your one now? A neuro simulators actually come in all sorts of forms of which are the pacemaker is effectively are one of them, but this one doesn't go to the heart. This one I believe actually connects into the nerves going into the or into the neck. but you can get ones that are connect to your spinal cord and other locations.

Now this one's actually installed in the subcutaneous pocket and I'll include a little photo of where that one's actually installed and then the little lie cable which we don't have our sadly which actually interfaces to these two. These two connections in your here, but there's actually multiple connections on here. you can actually see it's actually four pins so each one of those contains our two connections and the cable just goes off to the implantable device. And yes, this is a non chargeable thing.

It's got a built-in Lithium battery which basically effectively lasts the shelf life. I Don't think they actually give a like a guaranteed battery life for this thing, but it's like you know, it's like ten years in the unplanned order of the internal battery in there, which we'll take a look at when we do the teardown of this thing because obviously you don't need much current at all. Effectively, nothing to us stimulate the neurons so this thing could be running practically all the time and it's not gonna flatten the battery. basically shelf life.

So yeah, are incredibly low power device. Now this is the I Trial 3 from a company called Medtronic's and they're pretty much one of the leading are providers of these you know, pacemakers, neurostimulator, x', and other things. So this one I believe this design dates from 93 or there. abouts I don't know, when this particular one was are manufactured but they would.
You know a lot of design effort and certification goes into these things, so once they design them, they typically sold them for a long, long time now. of course these things use medical grade material because they are implantable or fully certified and tests of course it's got a titanium at case, it's got a poly urethane interface connector block up here and silicone rubber seals and other things and they're actually yes, they are little low hex screws. Basically you can get like a specialized tool which actually what comes with it I believe when you buy it, come straight out of the box with the tool to actually I get in there and adjust well. add tighten up the connector once you've plugged it in the other and just shove it in there and just rely on that friction.

They do actually tighten it up and they're very thoughtfully provided the penny out on there. There you go for the four connections there. If you don't want the doctor to get it backwards, that would really ruin your day. you coming out of surgery, doing cartwheels and believing that does solar roadways and you being a good practical ideas So I won't pretend to know the physiology behind all these things.

Let's get to what everyone here is for. Let's tear this puppy apart. I Think it's going to need the dremel for this one too. Ultrasonic Lis welded titanium case of course.

And yeah, that looks serious business. Hmm and bingo, we're in like Flynn Check it out actually. yeah. I went through like one and a half of those Dremel cutting wheels getting through that titanium.

But we're in and you can see we've basically got the that most of these spaces taken up with the battery here. Now, this is a Lithium Thionyl chloride battery very common in industrial and medical applications like this. They're typically you won't find them too frequently in any sort of commercial market or things like that. Now, these are actually are quite chemically reactive and they can be exothermic, so they can actually, you know, heat up and potentially explode.

But I'm sure that these are specifically designed internal, you know, manufacture very tight manufacturing tolerances to prevent all that stuff from happening. So I'm sure they've done their homework. and I'm using the Art Sugano microscope here to take a look now. This could actually be a some sort of ventilator alight perhaps and then sealed it off because these are wet electrolyte and it would actually react with stuff if it was if it actually leaked out.

of course. But look, we can. They've actually using the outside of the cases. They're the presumably the negative terminal there.

they've actually are welded. This is gold like big stud thing on there so that and then they can bond wire over their arm so they've actually soldered welded or whatever. that down to the can. and then they've got the wires buggering off in here through looks like a little sudden.
that feels pretty solid. I Thought that was like a some sort of plastic tube. It could actually be a glass tube or something. Maybe not entirely tirely, sure.

But anyway, it's designed be an insulating tube going through there, taking the wire off, of course, so that it doesn't there's no chance of it shorting out to the can here and shorting out the battery. But interestingly, you'll notice that we've gotten the double bond wires going over here like this: This is for redundancy. of course, in a critical implanted device like this, there's no way you're going to rely on one bond wire. Although they haven't said that over here, that goes to the connections.

They have actually just done the one bond wire going off to the case. So like, if that broke, maybe it's not a huge deal. I'm not sure why they decided to do one there, but all the other ones you can see through the penetrators here which go outside the case. they'd be sealed as that that is a silicone, yet that's rubber.

That's rubber. I'm not seeing sure if you can see that deform there, but that would be a silicone rubber seal around those penetrators there which go out side the case. That's the term for anything that goes through a sealed case like this is a penetrator and will actually go out and just have a quick squeeze under there. Then you can see the wires actually coming out there like that and then going into the little hex screws are in there.

Is that something? Yeah, that's sort of. Is that a real I don't think. is that a reenter herbal gel or something. Anyway, there's little lah I believe there's little hex screws in there which then screw down to the to the connectors inside there.

But yes, by the way, I have actually measured this battery and it measures zero. There's nothing coming out of so this one is completely and utterly dead. I'm not sure if 98 is the year of manufacturer that doesn't look like your traditional date code type stuff happening there, so I'm not sure what the deal is there now. of course the interesting stuff is the PCB and one of the first things I noticed of course were right captain.

A lot of people might be surprised to find tantalum caps in there because they notorious for you know, catching on fire and stuff like that. but these aren't just with someone hung low Things that they're getting from the Shenzhen market. these would be fully qualified parts. In fact, every part in this would most likely by law.

I Guess by certification actually required to be signed off by the manufacturer the manufacturers of these parts are Naka in their data sheets is very common to read. Not, you know, not suitable for implantable devices. If you want to implant them or using life-saving devices things like that, then you have to get specific permission from the manufacturer. so these would be very carefully selected, sort ordered, and certified and stuff like that.
And we're not talking about using these for, you know, really like high peak currents and uh, stuff like that. so it's not really a big deal. Anyway, we've gotten a ceramic substrate down here and you can see that we've actually got technically a ceramic hybrid because that if I can, if that focus come on, you can see down in there and that is a hybrid resistor with a little laser trim mark. You'll notice there's another one there as well.

So we've got two resistors. They could very well be our components on the top because I don't see any chips on here, so most likely on the bottom. But then we've got to our multi-layer ceramic caps. We've got different types here.

They'd all of course be specifically engineered, specifically chosen for the task. We've got one, presumably some sort of our trainee in there. What's a 133? I'm not sure those who are those SMD code aficionados can go look that one up. that is a 500 micro Henry inductor.

It's a bit hard to read that, but yeah, that's 500 Mike and what is that puppy? Is that? Another inductor XC 289 does. Looks a bit different, so I'm not sure. That almost looks like maybe that could be the coil for the receiver. Perhaps because they've got to have a receiver in this thing to communicate with it.

Well, at least receive instructions from the handheld patient unit who can, actually, you know, play around with the settings and whatnot for this thing. Now, as for this puppy, I've got a ceramic top on it. It's only two pins, so maybe. Is it.

uh, is it a crystal? perhaps? Um. I Don't know. Weird, but of course, one of the most interesting things in here. Look, it's a red switch.

They're our contacts there. Look, they're welded onto there. It doesn't look like this old. It looks like their world it down somehow.

and they're actually blogged in place like this. That's nice attention to detail of Quran They're probably a requirement of the production in our process that you actually blood them down first, like that, let it set, and then you come along and go. You know, world world like that as part of the production process. But and of course, the read switch.

That's a magnetic read switch and that looks like a normally closed one. Actually, that looks normally closed to me if you look at those contacts. so you can switch either the entire device or more likely just like the output or something like that on or off of IRA magnet, which your place are presumably on the back of your neck near where the unit is I implanted and that activates you Mike Rosario Read switch and you might notice this rubber here that just sits in that little pocket. I Really don't know what that's for.

It's some sort of space filler or something I don't know why they bothered. Beulah Beulah So what we'll do now is just try and leave this puppy out. It's gonna be stuck in there and see if we can access get the board out cuz I Think this battery has got a got to come out first yet that's held down with adhesive and that is actually a silicone adhesive because it's got to be. That's the only thing in sight allowed inside these things.
well, actually on the outside because I guess because this is on the ultrasonically welded inside. But yeah, we've just got an adhesive strip there so we'll just rip that off. sorry if you bond wire fishy and ADO's I broke it. Whoops.

But yeah, that battery certainly is dead. There's no other identifying marks on that either, so you can see how there's a so that yes, some sort of plastic eye carrier in there. So try and get a knife in there and I'm gonna have to break these beautiful bond wires. Um, bit of a shine, but we're gonna have to sacrifice this puppy in the name of engineering education.

I'm afraid I've already ruined it. was a thing of beauty is a joy. forever. getting the knife down in there wasn't - what? Come on.

Jeez, this is a really tough. I've tried to get the knife down in there but wouldn't have a bar of it completely stuck down. Probably All right? I'm pretty darn sure. I'm gonna have to apply a greater force on this to get it out.

I Expect the ceramic hybrid base to crack before I Get this out. Sorry for those who think this is beautiful and I shouldn't be destroying it. But oh, there we go. Yep, chipped it and you can see the bloody glue under there.

Ah, unbelievable. Somebody went ballistic on the production line. Why? But I think you can see what's gonna be on the bottom? In fact, I don't think there's any other components apart from that one big blob ASIC in there and trust me, they are running a six in side. This thing, it's not gonna.

You're not gonna find any sort of general-purpose micro controller inside one of these puppies. They're gonna be fully custom. a sick designed for ultra-low-power designed for the exact requirements of what this thing needs to do is. So yeah, it's just completely blobs.

I Don't think there's anything interesting under there at all those numbers. just some sort of production code. But yeah, I don't think there's much else in there. don't think I showed you that before the beautiful gold-plated end caps on those tantalum capacitors.

Ah wonder how much they paid for those puppies? Yep, I'm pretty sure that's the only thing under there is a gigantic chip I Don't know what size die that would be under there, but whether or not it's only a tiny die and they're just bond Y and bond wire and stuff out there just put in a huge encapsulants whole thing. I Mean you wouldn't need a hew? This is not. You know you're not gonna use it like a 15 millimeter die or something in there. But and you know, things like the cochlear implants and stuff like that have massive requirements I should have actually done this before I tried to attack that board in there I thought I'd bear it up and sure enough, our 3.7 volts ordered some wires on there.
Sure enough, 22 odd micro amps. So yeah, that's exactly what you'd expect. This is a 2.7 amp hour battery so you know it's basically going to last the shelf life. So this is the basic operation of it now.

Um, little tip: you can get the the magnetic hanger from your multimeter and you can use that. hopefully. does that does that change it? Something's changing and it's certainly starting to climb up. so maybe we've switched it on.

We've done something. so look I have no idea if I've damaged this physically. Those ceramic hybrids are pretty robust. They basically don't flex, they just shatter.

So I don't think that I've actually damaged that hybrid so looks like it might still be operational, but it's sort of steadily. the average currents increase in 23 microamps, slowly going up. I Think Well, let's actually take a quick probe of the waveforms here. I've got it on the battery common, so you know I have no idea where the absolute the actual wire reference is.

Let's start with the top one there. Ah, this is all 50 Hertz stuff. so too much of a coincident. yeah I can't see anything else.

That's the mains frequency. So what's going on there I don't know I don't even know the amplitude levels for our you know, nerve stimulation neuro stimulation techniques. So and yes, I've tried that with the magnet as well and there's pretty much nothing doing there. So sorry, tell you what though, we are getting something on one side of what I thought was that would that white ceramic package there which I I kind of guess was a crystal.

It's not, it's doing something else so that's a slow time base that's 200 milliseconds per division 1, 2, 3, 4 Like, it's just over 800 and you know, 810 milliseconds or something between those pulses. So like is that the stimulation period or whatnot? Mmm, no idea. And I can actually get the magnet to activate the read switch. There we go.

Let's try it again. Boom. There we go. Got it.

So unfortunately it looks like that's pretty much all we can do for this thing. and well, there's not much in here at all. The teardown wasn't as interesting as I thought it might be, but I didn't know what I was expecting. Really? I Mean it's not like it's a, you know, like, a cardiac pacemaker or anything like that.

It's just a neuro stimulator. low-power neuro stimulator that's designed to be implanted into the nervous system, the our spinal column, or the nerves going into the neck, or even a direct brain. I Don't think this model does the director brain stuff, but yeah, designed for neuro stimulation for pain relief and your chronic. You know, pain relief if you're desperate enough to get one of these installed.
If you've got one, as they let us know, leave it in the comments down below. how it's working for you, what the procedure was to install it, how you how it was, You know, until they have to calibrate the thing for your individual requirements. you know how often do you have to use it? Is it always firing? Or do you only put the magnet thing on the back of you to activate it? When you get in chronic pain or whatnot? let us know because I really don't know anything I Don't know anyone who actually uses one of these things, but I've only to believe they're you know, not that uncommon in the general population. You know, because there's like like I think it's five to ten percent of the population or something suffers from some sort of new neurological type pain.

So I guess there's you know, got to be. You know at least a partial percent of people that are chronic enough to warrant. Well, there's neuro simulators. so I hope you found that tear down interesting at least I mean the most interesting part of this is basically.

well, a lot of people say the boring part and it is, but it's critical is the certification of the design process. It can take years and years and years. and I've actually done some work for an implantable device company and they you know just the amount of effort that goes into a light. not only designing the AC chip, but deciding every single part, qualifying every single part that goes into it and everything else is just a ridiculous amount of work.

And if I'm conceiving the latest star product or you know, next generation product to when it actually gets released to market can be you know, like five to eight years or something like that. it is a long development cycle because you know implantable devices have to be ridiculously certified, so they certainly weren't trying to make this thing as small as possible. I Mean the new generations are probably thinner and smaller, but you know they've made no real effort to shrink that down apart from the ASIC of course, which probably does you know a fair bit. Um, but you know it's um, probably a fairly complex ASIC But yeah, I mean this is basically just you know it's some large-scale parts on here.

made no effort to get it down, especially with the connector and everything like that so you know these would pretty bulky inside you. but like I said, this is early 90s tech I believe it would have. that's when. Well that's when the datasheet the manual for this thing.

So and this probably would have been designed in the late 80s, so just take that into account. So thank you very much men who for us sending that in and I did actually get another one which is the prime advanced here. I actually got two of these so I was able to tear down that one, but maybe now in maybe in a separate video. I Can tell you on this, but it's probably very similar.
This one is actually our Spinal Cord Neuro Assam Neuro Stimulation. so it's actually a 16 channel job. So yeah, really much more advanced than this little. I don't know whether it's like 4 channel or whether or not it's like 2 channel or whatever with the pros, but yeah, 16 channel job probably extremely similar inside those and um, this one is the non MRI one you can actually get.

The latest version is like MRI compatible so you can put them inside MRI machines and you're not gonna like they're not going to explode or you know sort of be extracted from your body or whatnot. So yes, specific ones designed to be MRI compatible anyway I Hope you enjoyed that look an implantable medical electronics. If you did, please give it a big thumbs up. And as always, discuss down below, especially if you've got one of these, be really interested to hear from people who've got one of these puppies installed.

Catch you next time you.

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By YTB

21 thoughts on “Eevblog #1027 – implantable neurostimulator teardown”
  1. Avataaar/Circle Created with python_avatars Nicolas Jonasson says:

    Both monitor and manipulation of brain functions can be done wirelessly today (and are, on a massive scale), no bulky implants needed.

  2. Avataaar/Circle Created with python_avatars paul .a larner says:

    some tek scopes use the same chemistry batteries to power the nv ram.

  3. Avataaar/Circle Created with python_avatars Robin Sattahip says:

    That would be a bitch, having the battery in that thing pull a Tesla number. The fire department would be spraying water on your head for hours.

  4. Avataaar/Circle Created with python_avatars Robin Sattahip says:

    Having my head sawed open to install that thing would make the pain tolerable. My neurological pain went away when I got divorced in 1988.

  5. Avataaar/Circle Created with python_avatars Randy Havard says:

    My aunt had a similar implant as a treatment for Parkinson's Disease

  6. Avataaar/Circle Created with python_avatars Chicken Permission says:

    just cut it out

  7. Avataaar/Circle Created with python_avatars Chicken Permission says:

    hope it doesn't short.

  8. Avataaar/Circle Created with python_avatars James Halfhorse says:

    I have the Boston Scientific one wired into my lower spine and was about to get it wired into my upper when covid. It helps a lot. Charging it every week is a bit of a pain. Being an RF engineer when he started talking about modulation, frequency, amplitudes, etc and got to talking he showed me a lot about the programming that goes into it and left some options open for me to customize things within safe ranges. So yeah technically a cyborg. I have a remote, serial number and firmware revision now.

  9. Avataaar/Circle Created with python_avatars Fun XOR Profit says:

    To have a lithium ion battery installed in your body or take some pills, Iโ€™ll take the pills every time

  10. Avataaar/Circle Created with python_avatars Steven Clark says:

    Also as far as I know implantables tend to not be rechargeable due to possible expansion and durability issues. It's not like inductive interfaces are uncommon so charging to top up might be practical if not for the possibility of blowing up.

  11. Avataaar/Circle Created with python_avatars Stan Burton says:

    Pacemakers last around 10-15 years, depending on how often the unit has to shock the heart to keep the rhythm steady. But a neurostimulator has to send shocks essentially constantly, so the battery doesnt last as long. In certain situations where the electrical system if the heart has to be burned out due to tachycardia, the battery typically lasts about 5 years. I would expect the neurostimulator to last a similar time.

  12. Avataaar/Circle Created with python_avatars Dirk says:

    I have a Boston Scientific model in my back in 2010. It is the non-MRI safe version. The reason I heard that they are not MRI safe is not that the MRI will pull on the unit but instead the MRI can cause the wires and other bits to get hot. The hospital billed the insurance for $130,000 but the insurance company and hospital settled on $35,000 for my unit. I didn't pay a dime because I had already met my total out of pocket. It charges wirelessly and has a wireless remote control. For emergencies, these units can be turned off with a magnet but I never tested it. It feels like a tense unit when on. It goes to 100 on intensity but after 20, I am basically immobilized. Up near T4-T6 is where they installed the 32 electrode pad paddle. Depending on the program I have running, I can have 4 or more pads enabled at a time. The Boston Scientific rep was in the surgery the entire time to validate the install. The main issue I have is that when bending over the intensity doubles because the paddle moves closer to the nerve.
    UPDATE: My son and I placed a magnet near the unit when on and it indeed turned it off; however, it would not turn it back on. Only the wireless remote would turn it back on. It cannot be turned on with a magnet for safety reasons say you were driving a car and it came on because of a magnet. You could possibly wreck because it can be quite immobilizing. Not too mention, anyone could turn it on if they had a magnet near you or I suppose you were in a high enough magnetic field

  13. Avataaar/Circle Created with python_avatars Allan Skogsholm says:

    that white rubber thing could be there just to make sure that the battery doesn't make contact with the connector bit and to make sure that the battery doesn't touch the case and short

  14. Avataaar/Circle Created with python_avatars Jeffrey Murdock says:

    I have a neuro stimulator implant for my back. Had it implanted in 7/2019 but it's a different brand and is rechargeable wirelessly. It's a big help with my messed up back and the pain it causes.

  15. Avataaar/Circle Created with python_avatars Michael-John L. Mushill says:

    I am on my second spinal cord stimulator, both by Medtronic. Both of them are rechargeable so a bit different than that model. The reed switch is there for the same reason as a pacemaker has one, so emergency personnel can shut them down if need be. Mostly these things run nonstop from the time they are installed. On the controller you can set the strength of the pulse, did I mention they pulse, anyway the strength, the length and the pulses per second. They do have a clock in there somewhere as they will shut off 10 years to the day they were turned on. I know this as my first one, which was working beautifully at the time, shut down and I spent an agonizing two months without stimulation waiting on the doctor to implant another. In my case, chronic back pain with shooting pain down the left leg, this device covers around 40-60% of the pain and has cut my opioid consumption by over 2/3. It is a wonderful device and I canโ€™t say enough about the Medtronic company. Having it implanted is a semi barbaric procedure as you must be awake for the placement of the leads and they canโ€™t deaden the area either because you have to be able to feel it and tell them if the stimulation is in the right spot or not. Oh, and each lead has several (6-8) electrodes on each, you only use two on each lead at a time. By energizing different leads they can โ€œsteerโ€ the stimulation to cover the areas of pain.

  16. Avataaar/Circle Created with python_avatars BlueRose says:

    My dad has one that charges with a pad while he sleeps like those wireless phone chargers.

  17. Avataaar/Circle Created with python_avatars eren oz says:

    the name sounds very dystopic

  18. Avataaar/Circle Created with python_avatars Ridesharing Services says:

    You had two video cuts within the first 45 seconds all showing your fingers moving the implant device at the same angles and positions.
    The cuts are nonsensical, useless and seriously disrupt the flow of the video.

  19. Avataaar/Circle Created with python_avatars Akshay Maharaj says:

    "Coming out of surgery believing that Solar roadways and Ubeam are good ideas"……..this had me laughing hard

  20. Avataaar/Circle Created with python_avatars Hola! Amateur Tech says:

    Could it not communicate by pulsing the reed switch?

  21. Avataaar/Circle Created with python_avatars Dinant de Kruijff says:

    Hello there EEVblog my name is Dinant i am now 49 years old I have a neurostimulator for two years I just got my second one half a year ago because of already having a flat battery next year I need my thrith one which hopefully is rechargeable. Mine I directly connected to my spine because of the pain through hole my left leg and feet. Let me tell you I thank God that I have one now because of the massive use of morphine I used around 250mg of oxi and now just 120mg and my leg doesn't hurt anymore and I can take a walk with wife and kids I just bumped into this autopsy of you and what's if course very interested but this looks like a old one I have one which I can connect through Bluetooth and messed around with increasing intensety on/off and several kind of simulations its really a blessing for people who have nerve pains mine came after several operations on my spine and they fixed all vertebrae together so I could walk again but the pain never disappeared so that why I have such a stimulator to get rid of the faulty impulses to my brain. I could send you next year my replaced one to you if you are interested.
    Thanks for your work here and let me know. With kind regards Dinant de Kruijff from a beautiful village Enschede in the Netherlands

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