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Paddle Leads without Laminectomy?

Lala329LLala329 Posts: 283
edited 06/11/2012 - 8:44 AM in Spinal Cord Stimulation
My appointment to get everything set up for my trial went well and I was able to get my questions answered, especially after having some helpful insights from everybody on the boards. One thing I got confused about though is the style of leads:

I thought that in people who have not had laminectomies they could not do paddle leads...I can't remember where I read that, but it looked to me like you had to have had some major back surgery with bone missing for them to be able to sew those big suckers in.

My PM doctor said they don't do percutaneous leads on anybody because there is such a high rate of lead migration. This stunned me because I thought I wasn't even a candidate for a paddle lead. He said the surgeons do a paddle lead that is sewn in so it won't move. I go to a multispecialty clinic so they have staff NS's to do the permanent implant. I can't imagine how in the world they are able to sew in big old paddle leads without a bone window or something...I got confused, and then I thought maybe my doctor and I were talking about 2 different things or maybe I was using the wrong terminology about the leads? I have no clue. I want to be able to clarify this with my PM doc when I go for the trial, so I was hoping you guys would know if that sounds right that they can do paddle leads in someone without a prior laminectomy?


  • In order to place the paddle leads they will have to perform a laminectomy or laminotomy in order to access the epidural space. That's why the NS is needed for doing the implant. If they were only doing the percutaneous leads, then the PM doc could place them and the NS wouldn't be needed. That's why those who have an SCS implant done, who have paddle leads implanted, tend to have a more painful recovery.

  • See, that's exactly what I had read, but my PM doc assured me that a laminectomy was not necessary. I didn't specifically ask about a laminotomy, so maybe that was the miscommunication? Thanks for the reply...I'm glad I wasn't crazy when I thought the paddle leads required some type of bone removal. I'll have to clear this up with my doctor when I go for the trial...
  • If they did a laminotomy during your original surgery could they use that space from your previous surgery to put in the paddles or do they need to cut away new bone to insert the spinal cord stimulator?
  • You would most likely get a new one at the level where they place the leads.

  • I have the paddles and I had a laminectomy. This was done 3 months ago and I'm still sore .
  • My laminectomy was done at the time the paddle was implanted. I'm with you, Nurse Dina, and I'm seven months out since surgery.
  • I wish that i had seen this forum before my implant. But I still would have had done it anyway. I had my implant put in on July 13th. After taking off the bandages I start to fill this lump or ball like feeling. The doctor had told me that i had to have a T10 Lam to insert the stimulator but was so happy to finally get the Stimuator, that i knew they had to start somewhere, and didn't ask questions. Like I said I was so happy to finally get it, its my fault that i felt this lump or ball without prior knowledge that it is normal. As i said i spoke with my doctor on Fri. only for him to tell me that it is normal. In the mean time i looked at a video and saw what would happen during the Lam and i see why. Now i don't feel like a dumbie. And you know i really feel that i can with stand this discomfort because when all is said and done it is better than the pain that i've endured for the last 6yrs.
    I am so glad that i found this sight especially the SCS forum. It really enlighting to see so much info. SLH
  • I have paddles and had laminectomy 3 weeks ago. I think it will be worth it. I am doing real well. I had my post-op appt yesterday. I have a pain in my back that doc said is probably leisions forming and that is exactly what it feels like. That's ok. It will help hold that paddle in there. I am working with my rep on programming.
    May be a harder recovery but in the scheme of the long run it will be ok.
  • Chickard- I'm just getting finished up with my trial, get the leads removed tomorrow. I will be getting the perm in Sept and i just learned that I will have paddles placed. I was just wondering how you're recovery been? Did you have to stay overnight? Have you been in a lot pain? Sorry about all the quetions...I know everyone is different but I like to know what I might face. I have children at home so I am trying to prepare my husband and myself for what the recovery will be like. I've learned I don't really like asking the doctors too much about recovery. They always seem to have a different idea on how it will go. I was told I wouldn't be in much pain after the trial but for me that hasn't been the case. I can't wait till tomorrow....Take care!
  • When I had my surgery it wasn't nearly as bad as the trial was for me. Mind you, I had to stay in the hospital for four days instead of the expected 'overnight' (I had trouble with my blood pressure being too high/low at various times, insane vertigo, etc) but I'm always in the hospital longer than expected (3 days with my appendectomy instead of 1, 3 days in ICU and a week in the hospital total after my brain surgery instead of 1/3 respectively). It wasn't totally unexpected - I had even warned my surgeon ahead of time so he was prepared.

    I was definitely sore afterwards, but nothing like I was during the trial. My mom and I spent 3 days in Austin after I got out, and were then able to drive 4-5 hours to my grandparents' house. By the time we got there I was no longer using the walker that I'd been discharged with.

    I was off of most of my painkillers by the time I went for my 3 week post-op followup, and off all of them by the time I went for my 6 week. I was able to drive myself to my 3 week followup (it's a 3 hour drive to Austin from here) with absolutely no trouble whatsoever.

    If you have any questions, feel free to ask!
  • Looking ahead at paddle implant. Already had leads implanted in April and they both slipped down a vertebra. Had 99.9% pain relief until bad fall, now dr wants to do paddle because it's more secure. Questions... How long expected for hospital stay?(leads was outpatient). How long recovery? And pain level after surgery from 1-10?  TIA for your responses
  • Just had my surgery this morning with the paddle lead. It was done outpatient at surgery center. Pretty sore but tolerable compared to my normal pain. 
  • Just had the whole enchilada installed last Thursday.

    Laminectomy, paddles, Medtronic Stim. 

    Took about a week to get rid of the "knife in the back" feeling from the laminectomy. 

    Pain level wasn't that bad, 2 incisions made it a  little worse. Microdiscectomy was MUCH worse.
  • SavageSavage United StatesPosts: 5,427
    Hello Lilfeather28 !
    Welcome to Spine-Health
    Please click on link for helpful information!
    Spine-Health Moderator
    Please read my medical history at: Medical History

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