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Old 05-25-2009, 04:35 PM   #5
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Re: spinal cord stimulator questions

Hi Dev,
Spinal Cord stimulators are implanted to help cover nerve pain, not lumbar 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 leads are sometimes used in people who need to have the leads permanently placed, and it helps to make sure that they don't move once they are implanted. The leads 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 leads 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 leads during the testing, if they are pretty sure that the permanent leads 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 leads 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 leads is done with a needle, and the leads are fed through that to the spinal cord. If they do paddle leads, 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 leads. 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 remember 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,

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