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Time frame for SCS procedures

BotzBotz Central FloridaPosts: 223
edited 06/11/2012 - 8:27 AM in Pain Management
I'm a newly informed member of the failed fusion club and have been told my options are to have a complete redo of the fusion (new hardware/bmp)with about a 50% chance that it might take this time or try an SCS. Well here I sit (not for long as it kills me to sit here at the computer) ready to face reality. My PM doctor does not do the implant so I have to wait for a referal. May I ask how long from the time you decided to go for the implant until you had the Evaluation/trial and then the permanent SCS? I have been in pain mode for about 3 years.

Is the permanent SCS a full blown surgery or is it performed minimally invasive?



  • waited a little over a year between when it was recommended to me and when I went forward (but I had extenuating circumstances including moving. Had I not had to change doctors, would have been about 7-8 months.)

    First you will have a trial, usually 3 to 7 days. If that produces a pain reduction of 50% or more, you will move forward with the permanent placement.

    I had percutaneous leads, 2 of them. A small incision was made in my low back, and leads were threaded up my epidural space until they were in the proper position. I was awake for this. Once the leads were correct, I was put under and the hip pocket for the pulse generator was cut and formed in my upper buttock/hip region. Some people have it put in their abdomen. Also, the wires from the leads which are mid back (for lumbar problems) are then tunneled down to the hip pocket. This can cause soreness for several days afterward.

    If you end up with paddle leads, that is a more detailed procedure, involved a laminotomy mid-back (removal of some bone) and the paddle leads sewn in place. You have less positional issues with this (the leads are not free floating in epidural fluid), but it is a more major procedure. Same procedure with pulse generator placement and tunneling wires.

    I had mine put in 4 weeks ago and I LOVE IT. Can't say enough about it. Strangely, I never felt my hip pocket soreness at all - must have already been numb, as I have much lateral numbness in both legs. I have permanent S1 nerve damage, but nothing else was found that could be surgically done. I am a fusion success story with no nerve impingement. EMG diagnosed my nerve damage. I would say I have 80% reduction in pain at this point.

    http://www.poweroveryourpain.com is a great website with short videos showing you what is involved. Plus, if you find some testimonials that you relate to, you can contact those people through the website. They volunteer their time. You can ask them any quesitons you want. This website is for the ANS/St. Jude brand, but I found it helped me overall. I do have the ANS/St. Jude Eon Mini, though. My pulse generator is slightly larger than a silver dollar - it is tiny!! (The part in my hip).

    Take care and good luck!

  • BotzBotz Central FloridaPosts: 223
    Thanks for the great info Cheri. 7-8 months wow,that is too long for me to be hanging. My PM suggested this option a few months back and I was not ready to accept this was my destiny. My pain has gotten so out of control to the point that I had to stop working. I sit at a computer for 9 hrs a day. I saw my PM last Friday they changed all of my meds and I now have some relief from the nerve pain that constantly screams from my back down my leg. He doesn't want me to return to work. I can't stand being home. I'm really hoping that I can get this ball rolling soon.

    You say that you have permanent nerve damage. Is that from waiting too long to get the fusion surgery? I also have S1 nerve damage. I'm assuming it is due to the failed fusion.
    After the surgery my nerve pain disappeared, only to return at about the 4 week PO time frame.

    Again Thanks, I'm sure I will have more questions as this progresses.

  • Hi Art

    I guess you are in the US - I am in the UK & the process is slightly different here, but I too waited about a year from suggestion to implantation of the full system. Same trial & then waiting for the full implant - I had a laminotomy & paddles leads placed under a general anaesthetic & two days in hospital. I am about 10weeks post surgery & I wouldn't be without it. I still have some pain, but reduced opiates & 70-80% reduced pain scores & things are good.

    Some issues around restrictions for me but that is all part of having chronic conditions.

    I hope you can get yours sorted as soon as.
  • I was fortunate that from the time it was recommended that a trial be performed, to the actual trial, was only 2 months. I had been given an open invitation for a trial a year before that, but opted out and had surgery instead.

    I had a 3 day trial and the permanent implant was performed the day after the trial ended.

    I have a cervical spine SCS with 2 percutaneous leads and a rechargeable battery that gives me 7-9 days per each 3.5 hour charge (averages).

    My health care is provided by the military, so I don't have the big insurance hoops to jump through that most others do. Also I was given special consideration since I have to travel 7667 miles one way to the PM doc. My rep said otherwise it would normally be a 4 to 6 week wait between the trial and permanent implant.

    Good luck to you.

  • From the time I learned about the SCS to my final implant took a little over a year. I had some problems with the first doctor that was going to do the procedure and he left me hanging around for 7 months with no results. When I finally blew my top and canned him, I had to wait 3 months to get in as a new patient with my current PM doctor.

    Once I saw my new doctor for the initial visit, it took 4 months to get my trial done and permanent implant placed, which included insurance pre-auths and the referral/scheduling with a neurosurgeon for my permanent implant, since I have a paddle lead that had to be implanted through an open laminotomy.
  • I am at seven weeks out from first suggestion. I have passed the psych test and am waiting for the PM appt to discus what/when/where/how etc,etc....
  • BotzBotz Central FloridaPosts: 223
    Thank you everyone for your responses!

    It sounds like I might be in for another waiting game. Right now waiting for the referal from my primary Dr. January 1st I had to switch to a different insurance provider that now requires referals/authorizations. I have about 6 months worth of leave from my job then its long term disibility. Not a good option...I need to work another 15 years or so.

    I'm not looking for 100% pain free. Just let me cut down on the meds and have the ability to be somewhat normal again.

  • I'm in the same situation as you. I did have a stim trial after passing the psych evaluation. I was however referred to a surgeon and wound up having a fusion because of nerve compression. Well, I didn't get relief from it so now the SCS option is open again. I know it'll be a few months before I can start the process, so for now I manage the pain with medication.
  • That would be frustrating, have the trial, then get referred for surgery that did not correct your pain, well wait a minute.
    I did that too, I was promised the partial shoulder replacement would fix me right up, yeah, did not happen either.
    I just hope the scs works for me. If it does not. Well who knows whats next when they don't see anything wrong anymore?
    All I have been told is that I must have damaged some nerve or nerves when I landed on my head and shoulder. No one can see much of anything wrong that indicates the root of the problem. That is why they went towards the SCS with me. They know they can block the signal upstream of the damage. Well, they hope they can anyway.
    I think I have my head wrapped around the issues that may arise. I hope so anyway...
  • What kind of fusion did you have?
  • BotzBotz Central FloridaPosts: 223
    My surgery was a one level L5-S1 PLIF with cage and BMP. I think part of my problem is that the surgeon only used hardware on my right side. 2 screws and one rod. At the time I agreeded that less was probably better. Stupid me. The new surgeon I saw said what the hell? The pain I have is all on my left side.

    The lami I had in 99 was L3-L4, Can they place the leads in that area? Or do I have to have another lami higher up my spine?

    I haven't started any of the evaluations or trial yet.
    Hopefully this will happen very soon and go smoothly.
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