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How soon after a fusion can you get a pain pump or SCS?

Reformed1RReformed1 Posts: 257
edited 06/11/2012 - 8:47 AM in Pain Management
As I have painfully articulated in other posts, nothing is working for me. I am working fulltime and I am really struggling with the pain and the med side effects.

Tick...Tick...Tick... I would like to ask my NS or Pain doc to do a Pain pump by the end of the year so it will be paid by insurance 100%, but I am only 9 months post-op right now. What is the earliest that they will do it?

I'm at a point where any reduction in pain will be welcome and there isn't much left for me to try. Without this, I'm going to ask to go back out on disabiity (LTD). This is ridiculous to try to work like this.



  • I understand why you want to get something done before the year is up and can't say I blame you. I believe it takes a year to fully recover from a fusion but I could be wrong. I had my 2 fusions several years ago and do not recall what my Neurosurgeon told me but I believe he did day a year but I was allowed to go back to work in just 6 weeks.
    I would talk to my Doctor about this and see what he/she says.
    Sorry I can't be more help to you.
    Cheers :H
    Patsy W
  • I agree with Patsy. Pain pumps, SCS or in my case before my crack "a year post op" is when most surgeons decide if either the fusion failed (issue to fix with maybe another surgery), or the fusion is fine, but the pain and other issues are still unresolved. With that, my guess too would be a year. Have you tried calling your surgeons office to pose a question to them of this? I hope you know soon. Working with constant pain is the ultimate pits my friend. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    a year sounds right to me too. But they may want to investigate whats generating the pain. So you'll probably have a battery of tests along with a MRI or other imaging. I also had a hardware block, emg, every kind of injection there is. But for sure, they will want to see 100% fusion. Be prepared for a long process.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I understand your desire for wanting relief. I was in in your shoes at the 9 month mark several years ago and yes I work full time, still do. Granted, I sit at a desk all day. I had developed other issues along with the every day pain. It was suspected that my hardware was causing some problems and I was pseudarthrosis at 1 level. I ended up having my hardware removed, revision fusion at L4/L5, and a facectomy at L4/L5 and L5/S1. The procedure resolved most of my back issues and helped some with my drop foot. It didn't cure everything. It took another 18 months before I finally got my SCS last year. The moral of my long diatribe is that an SCS or pain pump is pretty far down the road before its considered.


  • hi buddy...I'm so sorry you are in such pain and working full time and having a hard time with it all.

    i think if you decide to move forward with this...have both trials to see which one would be right for you. does your PM doc do both of these procedures? Also, for the pain pump...I'd make sure I could get a few day trial...not just a one dose trial. I could tell you more what I think when you get closer to it.

    God bless you
  • I think all of us understand the pain and frustration of being in your position and being sick and tired of it all. Also I understand being a person who is used to taking charge of situations and working to a quick and successful resolution. Unfortunately with problems related to the spine and the CNS, quick fixes generally tend to backfire on people. Trying to force the issue with doctors can really backfire on us, especially if they are willing to accommodate you with your wishes just to prove a point.

    Do I know where that line gets crossed between what is smart shopping for the right PM doc and just finding someone who will do what you think is right for you? No. Do I become concerned when I read post after post from someone who is allowing others experiences good and bad to influence their decision making process? Yes!

    I really believe that all of us on Spine Health want to see you find the right treatment that will give you enough relief to live as well as work if you want to or need to. What my fear is, is that in your need to find a way to be free of your pain burden, you are grasping at any and all rays of hope, even though they may not be the ones best suited to your situation or injuries. I have had times where I have forced specific issues to go in a way I thought they should, and wound up regretting it in the end. Do I know how to tell when this is the case? Generally I do. It is when that little intuitive voice starts screaming at me from inside, telling me that what I am pursuing or doing isn't what I should be. (I hope this makes sense).

    I just worry that you are going to get yourself into a situation that you may regret later on.

    Think it through. Write it down on paper and look at it carefully. I hope you find some answers soon.

  • Not sure how to take that, C. I'm a little insulted by your post, but I appreciate your honesty. So, I will think through what you were trying to say versus what I thought I read. However, to suggest that I'm not thinking this through is a little tough for me to listen to. I'm thinking about this constantly. I'm a strategist, so I understand scenarios. Perhaps what you are observing is my exploration of options and not a knee-jerk implementation of every tidbit I read here.

    Just another thought about your comment about what concerns you most -- taking advice about other peoples' good and bad experiences and allowing them to influence my decisions. Isn't that the value proposition of this forum???

    I think I need a vacation.
  • Sorry if you feel insulted, that is not even anything close to my intent with posting. I am just very concerned and wanted to share with you why. It's kind of like doing a buddy check before you enter the water on a scuba dive or jump out the back of an aircraft on a parachute jump. Like running a checklist prior to take off even though you've flown for years and done the same things thousands of times.

    Listening to others experiences good and bad and then using that as a part of your evaluation criteria, is definitely a benefit. What worries me is when someone recommends a therapy they have never tried themselves and speaks to it as a subject matter expert or when others try to help each other justify why a specific therapy should be what works or does not work for you. I have no idea what would or would not work for you, and I certainly wouldn't push you to explore something that I have no real long term experience in.

    In my life, there have been times where I have made up my mind that something specific was just right for me. I would ignore that little intuitive voice inside that was screaming at me to avoid it at all costs. I learned my lesson the hard way and have since done everything I can to keep from repeating that pattern. I mentioned that because in spine surgery and treatment, there are very rarely "do overs". I wanted to say to you, "please think everything through well and don't make the same mistake that I have done". Again, only because when dealing with the spine 20/20 hindsight can mean that we are left in a world of hurt. (no pun intended)

    I hope this helps clarify things a bit better. If not please accept my apology.

  • I really do love you all and respect you for your intelligence and concern for others. Each time I read through this thread I find something I missed or something that could be interpretted a different way. That said...take a chill pill (my 80's upbringing coming back) everyone.

    Dave I can feel your anxiety over work from here. We've talked about this before. If you weren't worried about your performance on the job or losing your job would this question have even come up? Doubt it since you would be home taking whatever pills made you happy :) and doing PT or whatever else would help speed you along the road to recovery. So don't jump all over "C" when she is worried that you are looking for a quick fix that might not be in your best interest. If you read most, maybe all, of the responses they agree that one year is probably the minimum time to wait before looking at this option.

    All that aside have the doctors ruled out, to your satisfaction, all the things Dave mentioned? I know you need relief but don't you want to know where the pain is from first?

    As far as giving advice not based on experience...we all know that's a no-no but if you read carefully that's not the case this time. Each reply says something to the effect of "I've heard 1 yr is the minimum to look into this".

    Dave know that we all love you and want the best for you. Each person has responded with love and hope that you can find relief from the upset and pain that you live with each day. So please take our words and thoughts in the spirit they are given and know that we want the best for you.
  • Thanks for the Grrrr. It made me smile. :)

    I didn't think that I was jumping on anyone. If anything, I felt belittled by the comments being made. As I said I would do, I have stepped back from this to think more about what was said rather than how it was said. I'm sorry, but I still have an issue with the intimation that suggested that I am not thinking this through.

    I still don't understand this comment: "Do I become concerned when I read post after post from someone who is allowing others experiences good and bad to influence their decision making process? Yes!". Again, I would like someone tell me what the purpose is of this site if it isn't to solicit input from others.

    The little voice in my head is saying that unless I obtain better pain relief without more medication, I will not be able to keep my job. In other posts, I have enumerated the 15-20 different therapies and procedures that I have tried or continue to try. My doctor told me that the "one thing left that we haven't tried is a facet joint injection". He really meant a Medial Branch Nerve Block which I willingly had them them do almost three weeks ago and now my pain is almost unbearable. In other words, the last thing that they thought could help actually made matters worse for me. I only hope it is temporary.

    I have seen numerous doctors to obtain input about treatment options, so I'm not just relying on this site for input, although I do value the constructive comments I have obtained. I have heard from more than one doctor that an SCS is an option at the one-year mark. Well, in my opinion, there is no harm in beginning to look into that now (along with the pain pump option).

    The little voice in my head is telling me that this is a smart move. So, should I listen to the little voice in my head, or the little voice in someone else's head? (That's a rhetorical question).

    Have a good day,
  • Let me see if I can give you some additional thoughts to pursue. Has anyone done a hardware block to determine if the hardware is causing issues? Have you had an MRI or CT Scan to determine the cause of your pain? One would think that before you start doing end of the line solutions at a problem you understand what the root cause is.

    I think you need to rule out all the little things before you go down the SCS or pump route. I really do understand the working issue and being under-medicated.

  • wow...I would have taken that as a hurtful message as well. I guess the second explantion was better plus there was an apology, so at least that was done.

    Dave, she may be insulting me instead b/c I gave you "advice" about the pump trial without having a pump. I see what she is saying...I can't tell you from my own experience...but I've researched it up and down and all over the internet, in groups we are not allowed to mention and a couple members on this site and they are the ones who gave me advice not to take the one dose trial for the pain pump. So, let ME apoligize for giving you advice on opinions I have based on others with the pumps experience.

    Again, I'm sorry,
    God bless and yes, you are more than compitent to come up with your own decisions as you have had a very successful career requiring an intellegent person overseeing the work. I understand you appreciate the opinions of others, but it really comes down to you and your doctor and what is right for you.
  • Dave,

    I'm intrigued by your comment about an SCS or pain pump being the "end of the line". I take that as they either aren't very effective or they are really invasive, but I'm reading into your words. I would very much appreciate hearing your thoughts as to why you described them this way.

    I don't want to bore anyone again by listing the numerous test and procedures I have had done, but to answer your question, "yes", I did have a CT Scan and MRI which confirmed that my fusion is solid, all of the hardware is in place. My fusion looks great.

    The root issue seems to be scar tissue adhering to my L5 nerve root. I have had three attempts to address scar tissue using a Racz catheter, but it only provided relief after the second attempt. The third attempt was a bust.

  • It seems to me you are certainly doing everything you should be doing to be pro-active in your chronic pain issues. My neurologist told me that is so important. You also sound as though you are quite intelligent and have researched your medical problem and different procedures to try to have a better quality of life. I believe your question was simply how long after a fusion can you have a scs and pain pump. I am not posting to give you an answer and quite honestly I do not know. I do know however my neurologist has referred me for an evaluation for both and I am two years out from a Cervical fusion. My neurosurgeon I guess we will say did not want to see me anymore even though we did not know yet if I was fused. My rt vocal cord was paralysed and he simply blew me off. We recently had to move and start all over with dr.'s and therapies and now finally I am having mra's and mri's to get a better perspective as to where I am at with the fusion. My neurologist is however calling it a failed fusion since none of the symptoms have gone away only gotten worse. It sounds as though you are researching for a future decision which I have also been doing for some time. I did not take it as though you were going to jump head first into the SCS and pain pump. However, on the flip side I see so much caring and concern on this site that some may have taken it that you wanted this done soon so as so many posts I see there is a lack of communication and then assumptions are made and a simple question can turn into something quite different. I believe there was just some confusion here and since this is a wonderful forum where we can all share our experiences and and learn from others. So I just hope that you nor anyone else is offended and we just now move forward as the caring group we are. This site has helped me so much yet I do see alot of posts that get a little messy and I believe for the most part no one intends for that to happen.
    If you find any good info on the SCS and pain pump please PM me as my dr is pushing for it and I am simply scared to death to go through with it. I have already cancelled one appt. due to fear.
    I pray you get some pain relief and that all of us who are dealing with chronic pain in our daily lives can one day get the relief we so deserve.
    Best of luck
  • End of line means that there is no other treatment left. Your life is permanently altered the day you have either implant. This doesn't mean its bad, but you do have to make accommodations. I can only speak to the SCS because that's what I have. My problem is a little different, similar but still different.

    Jan, you may want to talk to "C" (haglandc) about an SCS for the cervical area. She has an implant and is doing exceptionally well. Of course there are limitations, but she can speak better to them.

  • nice post, thank you. Blessings to you as you look ahead to a possible pain pump. I'm also in the possible pain pump area right now. My doctor really wants me to have one, but he does not do them...so he is sending my records to a doc who does them. I have found it very important to research the pain pump all I can BEFORE I see the pain pump doctor or the Medtronics rep....b/c it is a money making procedure for them and I don't want to be "pushed" or "talked into" it...I want to do it b/c I've reasearched it.

    And Dave, I'm sorry I can not answer your original question about how long after fusion can you get a pump or scs...b/c I've never had a fusion. I hope you get your answer and I assume you plan to ask your doctor at this months' visit??

    God bless!
  • First of all, I want to publicly apologize to "C" for being so defensive toward her comments. "C", I understand that you read thousands and thousands of posts and that you see patterns in them, and in my case, you saw a pattern that caused some concern. I should have been grateful that you took the time to share your concerns in an attempt to help me avoid a potentially bad outcome. Instead, I became rather indignant and defensive. Again, I apologize for that.

    Secondly, despite a rough start with my Physiatrist and a terribly unsuccessful Medial Branch Nerve Block (3 weeks after the procedure my pain is still much worse than before the procedure), I plan to stick with this doctor in the hope that as we get to know each other, things will smooth out.

    Lastly, I want to say that I do appreciate this forum, the people who participate in it, and the people who run it. I have learned so much -- both good and bad, so that I feel enabled to have an intelligent conversation with my doctor. I'm very grateful for that.


  • I've been "lurking" in this topic ever since you started it, and feeling badly as your reactions swayed against what "C" was trying to say to you. I perceive you both as highly intelligent people and I know from my experience here in the forum that "C" will never knowingly say anything to offend or aggravate. She speaks from vast experience and a true caring for other spineys and she expresses herself in a straightforward, no nonsense way which I appreciate. And you are an intelligent man who is very articulate in expressing what you're thinking and trying to accomplish.

    I can see what happened here--you asked a question which came out of due consideration of your options and many other treatments, but you didn't preface your question with supporting background info to make it easier to understand why you appear to have made a leap to SCS and pain pumps. Even with a spine history in a signature line to assist, there are few of us who can carry in our memories all the background information on the members who post regularly, and that makes it very easy to potentially misinterpret the intent of a simple question, which is what I perceive happened here, at least in some measure.

    You're a big man to stand up and apologize, and you've just gone several notches up in my estimation! What uplifting and refreshing reading. I hope your quest for relief from pain is a successful one. If anyone can make their way through the maze of the medical jungle to a successful outcome, I have a feeling it will be you! Thanks for making my day brighter, and I wish you the best. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • No worries. The important thing is that you wind up getting the treatment that is best suited for your specific issues. I have learned that it can take a lot more time than most of us wanted to give it, especially when we hurt so much and the pain has consumed us and our lives. I wish only the best for you and all the others who are suffering. I look at lessons in life as opportunities to change the course I take further on down the road. Also to share that with others so that they may not have to travel as bumpy and winding of a road as I have. What good is knowledge and experience if we don't share it with others. I appreciate your comments and I am sorry that your thread got off on a tangent because I posted a different perspective.

    Linda, thanks for the nice comments. I hope that I am able to always live up to them as a member of the Spine Health community.

  • And C I'd like to apologize also for gettiong defensive for Dave AND assuming you were male (I have no idea why I assumed that...guess I never saw a differenciation with you). Another member brought that to my attention and I changed my post to say "she" and not "he". I am sorry too.

    And Dave, I agree, it took alot for you to come back and apologize...it's hard to do it. I think I just went off your reaction b/c you were 'insulted'...but anyway, nice to apologize!
  • No worries. Pain does not discriminate between the sexes and it's difficult at times to know who the person behind the username is.

    The important thing is that we be here to support Dave, each in our own way. Our uniqueness is what defines us and drives our responses.

  • Yes, C you are correct, My hubby often gets irriatated when I start talking about someone I met on here like they are a 'friend' of mine...he always says..."do you know she could be a man who's blah blah blah"? So, I get what you are saying! I guess with you I equated the avatar football symbol to a guy? Don't know why b/c I like football too!

    Thanks for accepting my apology.
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