spinal cord stimulator revision

spinal cord stimulator revision

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melanietn
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Joined: 03/11/2010 - 3:33am
spinal cord stimulator revision

Hi Everyone. I am 4 weeks post op from the Boston scientific spinal cord stimulator implant. I have had alot of pain at the battery/IPG site. 2 days post op the stimulation on my left side has been in my abdomen and ribcage, when it is suppose to be in my leg. The doctor told me Tuesday that they were going to have to go back in and move the lead because it must have moved a little. I have one 7 inch incision and they pushed the IPG over to the right side of my incision in my midline back. He said that they had to open the whole incision back up to move the lead. That just dosen't make sense to me. Has anyone had to have this done so soon after the implant? Is it easier to deal with the second time? I'm not sure that the pain I am still having from the battery/IPG is normal. He tells me that it's muscle pain and nerve from the scar tissue, but I think I know the pain is coming from the battery. Please any advice/experiences would be much appreciated. Thanks!

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haglandc (not verified)
Title: Member
Melanie

I have not heard of anyone having a single 7 inch incision for a neurostimulator implant. Normally there are two 3 inch (aprox size) incisions, one for the leads and one for the IPG.

Do you have a short torso possibly? I'm just wondering if instead of tunneling the short distance, your doc just opened the main incision to place everything. Can you ask him about it when you go for the revision?

I've had 2 revisions. Both were at about 1 year post permanent implant and they were about 2 weeks apart. The first was to install new anchors and recreate my strain relief loops. The second was to secure one of my lead wires coming out of the IPG where the set screw had come loose allowing the wire to pull out. I found it easier to handle the revision on the IPG that the anchors, but the anchors had to have additional tissue pulled in to create a covering.

Sorry that you are getting ribcage stimulation. I know how uncomfortable that can be. One thing to keep in mind, is that many times through reprogramming, that ribcage stimulation can be resolved. Changing the pulse width can drastically effect the depth of the stimulation and create a more pleasant sensation.

Keep us posted on what your doc has to say.

"C"

dave
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Last seen: 3 years 2 weeks ago
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Joined: 06/19/2008 - 10:57pm
Melanie

I started to comment on your other post when I decided to check and see if you created a new one. Welcome to the SCS side of the house. I do have some other questions:

What is the SCS trying to stimulate, i.e. Legs, Back, Arms, Neck?

Do you know what level the Leads were placed?

My IPG is on my left side, just above the belt line near my hip. Others can chime in as to where there placement is, but my father-in-law had his in his butt on the left side. It sounds like the IPG is rather high in comparison to others, how hard is it to charge?

Enough of the 20 questions for now and again welcome to our little group.

Dave

monib
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Last seen: 3 years 8 months ago
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Joined: 10/05/2009 - 12:56pm
Healing time is different

Healing time is different for everyone...but I still had burning and pain in the incision about 6 weeks after implant. How did they determing the lead had moved? Was it through a x-ray? If not then I would request a x-ray to compare with the placement at the time of the surgery...if there is no change...than I would think (I DON'T KNOW) reprogramming would be able to fix the area of stimulation. I know they moved my stimulation. I was feeling the stimulation in the bottom of my foot and should be feeling in be in my pelvi. With a good programmer they were able to get it back where it felt wonderful. Maybe your rep can direct you in the right direction.

ernurse
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Joined: 06/22/2008 - 9:09am
Pain at Battery Site

Don't know about revisions, but when I had mine placed initially, the doc gave me an rx for lidoderm patches to use after the incisions were healed for superficial pain where my battery was placed. I used them more for the lead incision which surprised my doc, he said most people complain more about the battery site incision.

I also had problems initially with the heat from the charger bothering my battery, but that was only when my incision was fresh. With some help from C and the Boston Scientific rep, I found out that the charger needs to be on when you are NOT all covered up. The charger can heat up to 106 degrees F and then it automatically turns off(no notice to you.) C gave me suggestion of wearing nylon not cotton garments over the charger which really helped with temperature and pain.

I'm almost 7 months out and I'm pretty well adjusted to the routine. I HATE abdominal or ribcage stimulation so I change my settings to fix it. I do get battery area discomfort if I bump it hard or lay on the floor directly on it. Overall, though, it's not a problem now. But I really liked those lidoderm patches at first, and ice packs when I still had staples.

Good luck to you, I hope it works out and you get to enjoy the benefits of it.

melanietn
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Last seen: 4 years 4 months ago
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Joined: 03/11/2010 - 3:33am
Thanks everyone for your

Thanks everyone for your replies. He has not done an xray. He used fluoroscopy.He said that it had to of moved since they could not get any stimulation in my left leg. He said just a fraction of an inch could cause that. what concerns me most is why would they have to move the battery to the other side? it seems like they would not have to mess with that at all. I know that everything I have read talks about 2 incisions and was baffled when I wake up with this one looonnnggg incision. I have had 3 back surgeries and the incision is only 3 inches long. I have met with the rep at his office 3 times since the surgery and each time she turns on the left lead and tries anything it is in my ribcage and abdomen. she has that lead turned off now. from what I understand the right lead is in the midline and the left lead is over to the left.I heard him say that my last visit. I am not sure what level. The original areas to be stimulated were my legs. Mostly the left from nerve damage. That is where most of my pain is. My right thigh has nerve pain as well but that side is working fine. It is very easy to charge. The first couple of weeks it wasn't but I guess it was due to the swelling and all. now I just put it on there and it automatically stops beeping. It is so great to have people to talk to that have been through the same thing. I really appreciate this site! Also, I am trying to decide if I should go ahead with the revision or wait a few more weeks til I am completely healed from the first one. I feel like it may not be as bad if I let him do it now and get it over with. atleast I won't have to dread it for as long.

haglandc (not verified)
Title: Member
Melanie

I found with surgery revisions, that it is far less painful to have them done sooner versus later. That's just what my experience has been.

There are several different scenarios for moving an IPG from its original positioning. However just because a lead fell down into "the well", isn't one that I've heard about or read about being cause to move the IPG. If I were in your shoes, I would definitely take a list of questions to the doc and find out what the reasoning is behind his decision.

Generally IPG's are moved due to charging problems, conflicts with other implants, to avoid excessive tunneling for lead wires, to avoid the need for extensions and due to possibility of damage from occupational hazards. Of course there are always exceptions to every norm, but these are pretty much the most common reasons.

I have a very long torso and have discussed moving my IPG to avoid tearing out my anchors from bending too much. However, we decided to leave well enough alone for the time being, since I have no other issues and can charge just fine. Kind of the theory of "if it ain't broke, don't fix it". So I just have to be a bit more cautious of how much I bend while doing things and I have to avoid Yoga.

Melanie do you know if your rep has tried to cross-talk your leads to see if when they work together, she can get good stimulation coverage without getting the ribcage stimulation?

Well keep us posted on what you find out. I hope it is good news and they can get your SCS up and running like it's supposed to.

"C"

monib
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Last seen: 3 years 8 months ago
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Joined: 10/05/2009 - 12:56pm
I agree ask questions before

I agree ask questions before you agree to anything. I was 12 weeks out when I had my revision. I wouldn't accept a "had to have moved" as an answer. My insurance wanted proof before they could schedule a revision. With the fluoroscopy they have pictures of exact placement and they can detect any movement. Again I was 12 weeks out and the 8 weeks of no BLT's started over...the rep had done many things with programming including cross talking...which seemed to really pull the stimulation into a fine tuned area. The stimulation was moved from my feet to my pelvic area with the use of cross talking. My rep will often call her supervisor to ask questions if she can't get it to work for me. I feel like I have a whole team of my own...and they are all great.

melanietn
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Last seen: 4 years 4 months ago
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Joined: 03/11/2010 - 3:33am
Thanks everyone!

I am going to ask alot of questions tommorrow! they want to schedule the surgery as soon as possible so that I can get some much needed relief. I am dreading the whole "starting over" recovery period but I think it will be worth it once I'm over it. I know that it works because the trial and first couple of days after the initial surgery worked great. I hope all of you have a great week!

melanietn
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Joined: 03/11/2010 - 3:33am
revision

Hi everyone! I am now 3 days post op from my revision surgery.It was suppose to be an outpatient procedure but I ended up staying 2 days in the hospital because of my blood pressure being too low and an awful headache. Anyway, He went in the same incision but did move the battery/ipg because it was tilted. It is working now for the terrible nerve pain in my leg, thank God. However, this one seems even more so tilted than the previous, it is really sticking out there. I don't know if you are allowed to post pictures on this site or not but I wish I could show the picture of how he did this.

Rwill
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Joined: 05/22/2010 - 2:42pm
So there are two incisions?

Melanie: Glad to hear your getting relief in your left leg. Sorry you had to spend 2 nights in the hospital that stinks!! Hope things keep going well.

So I'm just trying to figure this out, I should have my trial placed mid July. There will be two incisions approx 2 inches one for the lead and one for the battery pack.

ernurse: You mentioned wearing nylon clothing. Is that just when you are charging or do you where it all the time? Just trying to figure out what all I am going to need.

I have read that you will need button up shirts after the trial so you will not raise your hands above your head? Mine will be placed for lumbar/leg issues, is this still the case? I bought some button up shirts for my trial and have some stretchy pants ready to go.

Thanks for answering my questions.

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