spinal cord stimulator questions

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Vicky:

Thanks so much for answering Dev's questions (as they are my questions too). I may be headed for an SCS soon.

Did they implant your battery pack in your buttocks? My concern is I may face a knee replacement in the next 10 years and I didn't want the battery pack to be somewhere associated with a leg that may need surgery. I've also heard of it being implanted in the abdomen.

Thanks
Karin
 
I just have to say my husband was on very high pain medications for a few years...200mcg of Fentanyl pain patches along with many milligrams (60 to 80)of Oxicodone's. It was because of the high pain meRAB he decided he wanted the SCS so he could reduce dosage and always feeling like he was living/working in a fog. Of course he was seriously dependent on pain meRAB which has nothing to do with getting the SCS. The mental health evaluation is just to be sure you are a somewhat stable person. You can be on serious pain meRAB and not have a mental health condition. This mental health evaluation is required by the manufacture of the product not by the doctor...the surgeon of the implant can even give you the mini depression test. Half the time the patient takes it as part of the paperwork you fill out a new patient at the doctors office...or the surgeon can send you to a psychiatrist to do a quick evaluation...it is to be sure you understand that the back stimulator is not going to be the cure to all your problems. Anyone that has serious back pain is always going to have high pain management but my husband wanted off of some of the pain medications and having an implant was his only option. After you have the implant then you learn how to program the implant to cover the pain as you SLOWLY decrease the medications...this is very slow process and as you decrease the oral and patches then you will increase the stimulator to cover you as you reduce the medications. Both his trail stimulator test and the permanent stimulator was done in the same day clinic by the same doctor...the doctor can be from any specialty with training in the procedure of implanting. HusbanRAB doctor put the stimulator in with the the SCS representative in the surgery to advise the doctor on placement. The whole SCS process is done differently from one place to another. Good luck.
 
Hi I am having my SCS surgery on Sept-23-2009 Lower Lurabar, I fell at work from a scaffold and have 2 hurniated discs and a bulging disc the back pain and leg pain has been so bad for 18 months and I have nerve damage whuch is causing my left foot to be cold-hot nurab tingly and always there is pain in my toes and foot ,There also removing a piece of the Foramina there calling it a Spinal Cord Stimulator Implant & Lamenitomy is this common or is that an exrta proceedure. Also will I spend the night in the Hospital ?? and how was the pain after can you walk or get around once you get home or are you pretty much bed ridden for about a week. They did say they want me to start walking about a week later twice a day 200-300 yarRAB then increasing up to a mile or 2 which I cant wait to start waliking Also is it true you have to wait 8-10 weeks before you can start Physical Therapy this is what I am hearing also you I should not bend lift raise your arms pretty much be very careful for this 8-10 week period ??.

Thank you, Bob
 
Hi Dev,
Spinal Cord stimulators are implanted to help cover nerve pain, not lurabar back pain. Some, and I do mean some get some minor pain relief in their low backs, but that spinal cord stimulators function is to cover the pain signals sent through the spinal cord and it's nerves. If you do decide to go through the testing and the implant, don't expect coverage or easing in your low back pain. If you do happen to get some, it is not normal and your doctor or the representative from the implant company should not promise it to you. If they do, find another doctor.
Do you have a lot of nerve pain, pain down your legs , feet, heels, etc? That is the pain that the stimulator is supposed to help relieve. A positive outcome is a reduction of 50% or more of your nerve pain. Anything less than a 50% reduction is supposed to be considered a negative outcome and implanting the permanent unit is not supposed to happen.
The paddle leaRAB are sometimes used in people who need to have the leaRAB permanently placed, and it helps to make sure that they don't move once they are implanted. The leaRAB used during the testing phase are usually wires with electrodes in them. Those are placed next to the spinal cord and are held there when scar tissue grows around them. They sometimes do migrate and need to be replaced to the original location. Paddle leaRAB can be used in areas where more coverage is needed and those are anchored to the vertebrae by doing a hemi- laminectomy. I have read that some surgeons will use the paddle leaRAB during the testing, if they are pretty sure that the permanent leaRAB and stimulator will work.
As far as pain medications after a scs implant goes, most people continue to use pain medications simply because the scs is not /does not cover mechanical ( low back pain).. I would ask your Pain management doctor if he continues to prescribe pain medications after a spinal cord stimulator implant, because there are some who do not. You want to make sure of that before you go ahead with the trial or permanent implant.
The trials are usually same day surgeries, unless they are doing the paddle leaRAB and in that case, some doctors will keep the patient in overnight to make sure that things are okay post op.
The incision for the wire leaRAB is done with a needle, and the leaRAB are fed through that to the spinal cord. If they do paddle leaRAB, it is usually about two inches or a bit more, depending on the area they are putting the paddles.
The permanent unit is usually implanted below your belt line in the buttocks, although some people prefer it in the stomach area instead. That incision is usually a bit box shaped , depending on the size of the permanent unit.
In both the trial and the permanent implant, you are not supposed to raise your arms above your head, after the permanent implant, it is about 6 weeks, so that scar tissue has a chance to form around the leaRAB. And of course, the no bending, lifting or twisting for a few weeks as well, for the same reason.
I have read the good and the bad in implanting these units, but do your research and if you can, talk to people who have had them, who decided not to, and find out why. It is just as important to know the cons, if not more important, as the pros of any procedure in back surgery and treatment.
Just remeraber if you are not getting at least a 50% reduction in your pain, then implanting the device , at this point, may not be your best option.
Best of luck to you,
Back
 
thank you so much for your post. it helped me out tremendously. I have terrible disc pain, but no anatomical reason for it, which is why my PM thinks i'm a good candidate for the SCS. Thanks for doing such a good job of explaining this to me!
 
I have a question about if I compare with spinal cord stimulator ( SCS) procedure and minimally invasive spine surgery. (MISS) which one has less risk than another one or they are almost same and no different at this point? The risk I mean is the incision, remove part of bone, surgery time and recovery time. I thought originally that SCS maybe is more safe than MISS. Maybe I am wrong.
 
Pain Management doctors can do spinal cord stimulators. There are some orthopdic spine sureons and neurosurgeons who do it as well. In my case they referred me to my PM doctor for evaluation and consideration for SCS. Right now I am not moving forward with this as it appears I may need further surgery first.
 
brody,
If you can tell me what kind of your doctor recommended you to do SCS ( Orthopedic or Neuro surgeon?) . The reason why I ask this question is if your SCS
 
Thanks ! SpineAZ ,
I don't expect that you reply to me so soon. now I only have
two procedures can be tried before surgery. SCS and VAX-D.
I hope your further surgery will be successful.
 
I believe that the SCS is semi-permanent in that it is implanted, but if you, for any reason, wanted it removed, it can be taken out. right?
 
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