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SCS paddle in Cervical area?

AnonymousUserAAnonymousUser Posts: 49,670
edited 06/11/2012 - 8:38 AM in Pain Management
Hi everyone,
My fiance has a Medtronic SCS installed with percutaneous leads that worked great for about 2.5 years. The leads have migrated drastically and no longer work at all. So his doc has advised him to change out the equipment to a Boston Scientific device that has a paddle instead of two leads. The surgery requires a partial laminectomy to install the paddle.
My question is...the docs we've seen (one neurosurgeon, one orthopaedic) in Virginia have only installed these type paddles twice in the cervical area. Yep, that once each! They both said that the procedure is very rare in the cervical area. Has anyone out there had this done?
We're very nervous about having a "new" procedure done in such a sensitive area, and would like a more experienced doctor if there is one out there anywhere! Any suggestions would be appreciated.


  • I thought all brands of stimulators came with both kinds of leads and it was up to the Doctor on which kind he used. The percutaneous leads are first used because they are easier to install.
    I could be mistaken and someone with a Medtronic can please correct me.
    If this is so, then all they have to do is change the leads, not all of the equipment.

    I was told by ny pain Doctor who did my implant that my stimulator could stop helping my pain in a year or two. I ask what could be done then and he said...We will cross that bridge if we come to it. At that point I was desperate for help with my pain and thought a couple of years of relief were better than none.
    I am sorry I am not more help to you. I know there are some on here that have cervical implants and can tell you about theirs.
    Best of luck.
    Patsy W
  • Thanks for replying, Patsy. It would make sense that less would need to be replaced if they used the Medtronic paddle. The doc that we saw wants to change us to Boston Scientific...though they don't give a reason. I didn't question whether it would all have to come out if we stayed with Medtronics.
    Thanks for the lead! Good luck with your implant.
  • It has been told on here that many docs prefer the paddle leads in the cervical area due to movement of leads and loss of coverage. That being said, since it is in the neck most everyone first gets the precutaneous leads and everyone hopes it sticks in places and works, plain and simple.

    Can't really comment on the doctors experience. Is that TOTAL paddle leads or cervical only? If they have done many paddle leads elswhere then the fear may be unnwarranted. I'd ask for another consult, the more the merrier. Think about it, even if you have to travel. It is worth it to find your comfort level with this type of surgery.

    I have a single cervical lead and have often wondered if it fails or moves, will I , would I allow the surgery for a paddle. On a good day, NO, I would not, but on those bad days I would sign anyones name they asked me to put on the paper. Since the previous leads worked so well I would most likely be looking for a doctor I was comfortable with. I have heard many good things about the paddle leads over the precutaneous when installed in the cervical area, much more stable coverage.

    That is really going to be a hard choice to make. I hope you find the right answer
  • I would have to agree with Wrambler. I would get another opinion.
    I know some or most Doctor only use one brand of stimulator for what ever reason. A kick back perhaps?
    The pain Doctor I have only implants ANS brands. I know they all have both kinds of leads.
    I do not see the advantage of one brand over another....but that is just my opinion. They are all supposed to block pain signals from reaching your brain.
    Unfortunatly for me my permanent implant has failed. I get NO relief from my pain and am now waiting for a pain pump implant.....if I agree to. I think I have had my spine messed with to much now.
    Best of luck
    Patsy W :H
  • Another thing to keep in mind about cervical spinal cord stimulation. The dura thickness in the cervical spine is thinner than in the lower areas of the spine. The amount of "power" required to stimulate most areas needed with a cervical SCS is far less than a thoracic or lumbar SCS.

    A common issue with cervical SCS is the depth and in essence "overstimulation" that easily causes chest wall stimulation. When this occurs, it makes breathing difficult and basically feels like the individual is having a heart attack.

    Paddle leads are typically more robust and placement in the cervical spine which has the greatest range of motion, can actually run the risk of damage to the lead itself over time. Basically the lead can fail due to it's own "repetitive motion injury" for the lack of a better term.

    This is how it was explained to me by the doc and rep.

    That being said, I understand the desire for a more robust system for the cervical SCS. I would jump at the chance to have something like that, however I am very grateful to have something that is proven to work and does work. If in the future paddle leads are designed specifically to address all the issues with the cervical spine, I'd be more than willing to give it a shot, were my current leads to fail. Right now though I wouldn't take the risk of losing what I have.

    Belinda, your fiance has to make his own decision based on the information his doc and rep provide him and his own intuitive voice. I wouldn't want to be in his position. When I had one of my wires come loose from the IPG, the doc and rep discussed the possibility they may have to replace the entire system including leads. They forewarned me that regaining the previous level of stimulation coverage might not prove successful. It is not easy to replace a lead and get it into the same or similar area, due to scar tissue developement and the changing mechanics of the spine.

    Best wishes,

  • I appreciate everyone's advice. We did find a neurosurgeon locally who has done many cervical paddle implants. He believes that the orthopaedic surgeon could do the surgery well since he has implanted paddles in other regions of the spine. If we held out for the more experienced neurosurgeon, we would have to wait a little longer to get a surgery date. I'm sure you all know - better than I do - that days can get pretty darn long when you're waiting for some pain relief. So, my fiance has decided to continue with the orginial surgeon. I will post after next week's surgery. Wish us luck, please.
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