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Old 01-21-2007, 04:06 AM   #1
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Help! Where are SCS probes placed for L5-S1 pain?

Hi folks,
The down and dirty: Left Lat. L5-S1 disk blown, had surg., I'm on mucho meds for the last 6 years... New Doc is suggesting SCS.

My question; If they are going to implant an electrode next to my spinal cord, WHERE do they place it to control the pain coming from my L5-S1 injury? Do they implant the electrode right into the L5-S1 space or somewhere further up the spine (L1-L2? T12-T11? or where??).

Essentially, what portion of the spinal cord must be stimulated to relieve pain from L5-S1? I have always assumed that the electrodes would be placed where the pain is originating (L5-S1 area). This would be a problem as I have aracnoiditis and major scar tissue from previous surg. If they place the electrodes into the L5-S1 area, I'm worried that more scar tissue will be produced. If the SCS isn't succesfull, more scar tissue created when they remove the electrodes from the L5-S1 area.

I have been told that the electrodes are inserted well above the L5-S1 area, further up the spinal cord... perhaps at the L1-L2 or T12-T11 area.

Does anyone know where they place the SCS electrodes to "block" pain that originates at the L5-S1 nerve root? If they are going to place the electrodes into the messed up L5-S1 space, I may NOT proceed with the SCS procedure (I don't need more scar tissue!).

Maybe someone else out there has had this procedure to block pain originating in L5-S1 area and could tell me WHERE they implanted the SCS electrodes.

Thanks All!

 
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Old 01-22-2007, 11:54 AM   #2
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Re: Help! Where are SCS probes placed for L5-S1 pain?

It's placed at the sight of Injury Tim. A lead is about the size of one of those childrens bandaids that warps around a 3 year olds finger twice. On each band aid type lead there are 4 electrodes that look like watch batteries, One is negative and the rest positive. The negative lead needs to be placed directly over the worst area, so the lead may have the negative on the very end and stretch from L5 to L4, any farther away and it's not going to work.

Better placement would likely have the negative at the gap between L5/S1 and the rest running up the side of the cord at L5. A lead up at T12/L1 won't help at all.

There have been new products introduced to prevent scar tissue and to treat arachnoiditis. Considering you don't know where they place the leads, doesn't it seem like a giant leap to rule out the SCS if they happen to place the leads somewhere you think they shouldn't place them? Is there a more substantial reason you think the right place, is the wrong place? It's actually an opportunity to clean up some of the scar tissue, paint it with an inhibiting agent or use latex sheeting to prevent regrowth of scar tissue and then secure the lead in place.

Sometimes what seems to be an obvious risk really isn't. It's the only chance the thing will work.

Good luck, Dave

 
Old 01-24-2007, 10:21 AM   #3
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Re: Help! Where are SCS probes placed for L5-S1 pain?

I am getting the trial of the stimulator in Feb. after kids activities take a break! From what I have studied and learned from pain doc it is placed above the surgery site so that it can block the pain message. I don't know if this is the same thing you are getting, I am getting a dorsal stimulator. The wires are thin and will be put in under local anesthesia and I will have the control unit coming from the wires out of my back. I did research on the net and found the manufacturer of the one my doc will use. Lots of info. The trial doesn't sound any scarier than the epidurals that didn't work.

It may not be the same thing as described before for you, I haven't heard of anything that big or bandaid like with my procedure. Maybe this helps!

 
Old 01-24-2007, 11:08 AM   #4
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Re: Help! Where are SCS probes placed for L5-S1 pain?

Perhaps a band aid is a bad discription, It's a flexable piece of material that's about an inch long and 3/8thsd wide with 4 or 8 electrodes, each electrode can be individually controlled but the idea is to put the negative electrode directly at the top of the sight and try to disrupt the signal from there on up.
Good luck to both of you. Dave

 
Old 01-25-2007, 09:53 AM   #5
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Re: Help! Where are SCS probes placed for L5-S1 pain?

Shoreline.....

Been reading your posts and am very interested in your story...I see you've had multiple surgeries and most recently a 6 level fusion...I am scheduled for a 5 level fusion and am a bit nervous have not been able to locate anyone that has had more than a 3 level. If you don't mind me asking, what started your problems, and do you feel that the surgeries were worth it??

 
Old 09-23-2007, 07:12 PM   #6
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Re: Help! Where are SCS probes placed for L5-S1 pain?

I have four rods and six screws, I'm fused from S1 thru L3-4. I have extreme low back pain and leg pain also. I had my scs trail several weeks ago. The best coverage of pain came when they placed the electrode mid line at T8-T9. The doctor came in lower and went up to T-8 and 9.
Hope that helps,
Jeff

 
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