Typical Questions and Answers on Spinal Cord Stimulation

Typical Questions and Answers on Spinal Cord Stimulation

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Typical Questions and Answers on Spinal Cord Stimulation

Questions and Answers – Getting a Neurostimulator

* How will my doctor know if I am a candidate for neurostimulation?
* Why do I need to take a screening test?
* How long does the screening test take?
* Will it hurt?
* Can I have pain medication during the screening test?
* Will I receive the same relief that I get during the screening test when I receive my permanent neurostimulator?
* After the screening test, how long will it be until the neurostimulation system is implanted?
* What type of anesthesia is used during the implant?
* What is the average length of the hospital stay?
* How big are the incisions?
* Are there other side effects associated with placing the lead so near the spinal cord?
* Is spinal cord damage a possible complication?
* Can a previous abdominal incision be used?
* Between which vertebrae are the leads placed?
* Will I hear or feel the neurostimulation system inside me and will people notice it?
* Can the neurostimulator be removed?
* Will my insurance company pay for a neurostimulator?
* Is the procedure covered by Medicare?

How will my doctor know if I am a candidate for neurostimulation?

Talk with your doctor about your goals for treatment. Your doctor may do a screening test to see whether neurostimulation will provide adequate pain relief.

Why do I need to take a screening test?

Your participation in the screening test allows you and your doctor to evaluate whether you are a good candidate for neurostimulation treatment. The purpose of the screening test is to determine your response to neurostimulation, if it reduces your back or leg pain, if it helps you meet your goals, and whether a neurostimulation system is the right pain treatment for you.

How long does the screening test take?

The screening test period lasts approximately 3 to 10 days.

Will it hurt?

You will have local anesthesia when the leads are placed. There may be some occasional discomfort during the procedure and you may have pain at the incision site once the anesthesia wears off. You should not have pain or discomfort during the rest of the screening test period.

Can I have pain medication during the screening test?

Your clinician may reduce or withdraw your oral medication 1 to 2 weeks prior to the test. During the screening test, oral medication may be given for breakthrough pain. Never stop taking your prescribed pain medication without first consulting your clinician.

Will I receive the same relief that I get during the screening test when I receive my permanent neurostimulator?

If the screening test has been successful and you go on to receive the permanent system, your pain relief may differ slightly. This is because the leads may be in a slightly different location than during the screening test. Be sure to tell your clinician about the way you feel so that changes can be made that will give you the best pain relief possible.

After the screening test, how long will it be until the neurostimulation system is implanted?

If the screening test is successful, you and your doctor will discuss when the system should be implanted. Some doctors prefer to do the implant right away while others prefer to wait a few days.

What type of anesthesia is used during the implant?

Typically, the implant of the neurostimulator is performed under general anesthesia. However, you may wish to talk with your doctor about other options.

What is the average length of the hospital stay?

Depending on your doctor's preference and hospital policy, a hospital stay may be recommended. However, the procedure may be performed on an outpatient basis, which means no overnight stay is required.

How big are the incisions?

There are two incisions. The one for the neurostimulation pocket depends on the size of your neurostimulator. The other, made on your back, is 2 to 3 inches long.

Are there other side effects associated with placing the lead so near the spinal cord?

In rare cases, you may experience a "spinal headache." A spinal headache is caused when cerebrospinal fluid (the fluid that surrounds your spinal cord) leaks out from the intrathecal or epidural space. This headache may correct itself, or your doctor may treat it.

Is spinal cord damage a possible complication?

In rare cases, spinal cord injury may occur from surgical placement of the lead.

Can a previous abdominal incision be used?

No, because the incision needs to be made where the neurostimulator will be implanted to help properly anchor the device.

Between which vertebrae are the leads placed?

This depends on your specific condition and the results you received from the screening test. Your doctor will advise you of the recommended location.

Will I hear or feel the neurostimulation system inside me and will people notice it?

The neurostimulator does not make any noise. The device does not normally show through your clothes. It is usually implanted in the lower abdomen, where it is most comfortable and least visible. It may be felt as a small bulge under your skin.

Can the neurostimulator be removed?

Yes. The screening test is designed to minimize the possibility that neurostimulation will not help manage your pain. If you no longer need the neurostimulator or change your mind about the treatment, your doctor can turn off or completely remove the system at any time.

Will my insurance company pay for a neurostimulator?

Many insurance carriers will pay for neurostimulation. However, as with many pain treatments, your doctor will have to get approval from your insurance company before you can receive treatment. Consult your doctor or insurance carrier for more specific information.

Is the procedure covered by Medicare?

Neurostimulators are approved for coverage by Medicare. Medicare will pay 80% of the cost as long as the procedure is determined to be medically necessary. Talk to your doctor about the Medicare Conditions of Coverage.

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backpainzz
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Last seen: 11 months 2 days ago
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Joined: 08/27/2008 - 7:55pm
Charging the stimulator

I know they said I would need to recharge it for about 4 hours every two weeks, Thinking I didnt think to ask how its charged, cant it be done while sleeping, watching tv, is there a belt that you wear so the remote and stem touch? since I wear low rider jeans then NS said he would place it in my lower right back, and I also told him I sleep on my left side, Tues nov 23 is the BIG day. Thanks Rose

hatcher6040
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Joined: 03/28/2011 - 3:15pm
Spinal Cord Stimulater

Hello,
I am considering having a spinal cord stimulater put in. I have had three back surgeries and am still in a lot of pain. The first surgery involved a micro disketomy at my L4/L5. I had some relief for a couple of days and then right back to the major pain in my legs and back. I went back under the knife two months later after discovering that my L4/5 had reherniated and my L5/S1 had herniated. I was very carfeul in my daily activities during my recovery. I then had a series of unfortunate events.. I fell flat on my butt after an ice storm and things went down hill from there. Right after that fall I slipped and fell down the stairs at the house ( I live in Alaska so ice and snow are inherent risks of being Alaskan). I went back to the doctor and after another series of MRIs/ Catscans found out that both levels were herniated again. After much hoopla with my pain management doctor and surgeons in Anchorage, I decided to seek out more advanced help in the lower 48. Last August I underwent a disc replacement @ L4/5 and fusion @ L5/S1. A year later I am still in a lot of pain.... My doctor suggested that I consider a spinal cord stimulater. It scares me, having to live with this device, but the options are- existing on massive amounts of pills. Can anyone give me their take on living with this thing? Is it worth it or should I just continue living on pills?
Thanks,
Scarlet

gloriib
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Joined: 02/15/2013 - 8:59pm
neurostimulator lower back

I had a spinal fusion last May and my Dr. now wants to do the neuro stim screening test. The fusion was on L4-L5 and the very next day one of the screws fell out and they had to re-operate a week later to remove the two scres on the right side. Since the surgery the sciatica is gone but pain in my lower back persists. How effective is the stim for this area.? I am 63 years old and have so much trouble walking sitting and standing. Will the stim really help one or more of these symptoms? I need feedback from those of you who have had this proceedure, please.

a1m1bishop
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Joined: 02/25/2013 - 8:42pm
spinal cord stim

Hi there I am contemplating the spinal cord stim, but am very scared after reading a lot of the information on the web...I am that if it can go wrong it will go wrong girl...I have had 4 back surg...with the last being a fusion revision of l4 l5 s1 seem to have exhausted all avenues and am now told I have failed back syndrome....anyone got any advice for me

pandqmama
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Joined: 11/03/2012 - 7:32pm
I am in the same situation

I to have fbss after only two back surgeries. I am waiting the permanent implant of the scs, had the trial this past November. I also am concerned of the things that could go wrong, but the amount of pain I live with drives me to try almost anything. There are the horror stories but there are also success stories too. The trial went very well for me and I am relieved that it even worked for me. Has someone told you that you were a canidate for scs?

jiffrey
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Joined: 09/21/2011 - 3:33am
Post Op Spinal stimulator implant five days

I just got my implant on 07/26/2013 and I am in the first stage of recovery, thank goodness for ice it has helped. I have notice that as the pain from implant leads goes down more pain from the battery implant, hoping ice will cure this. I have been using the device and have slowed considerably on pain meds. I will be seeing the St Jude person to go over more control options. I have crossed every thing I have in hopes this gets me off pain pills for the most part and back to a more active life style and work life. Fusion from L3 to S1.

Jeffrey Alexander

johnand carlal
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Joined: 08/01/2013 - 6:00pm
4 years now with SCS

I have had fusions in L3 and L4 , L4 and L5. Then I had the stimulator implanted. This has helped with my leg pain but not with my chronic back pain. There are some days I could not even get out of bed. In Jan of this year, I started to get severe pain in the right buttock and it extended down my right leg. I have always had butt and leg pain but nothing like this. The pain went into my hip when I walked more that 5 mins. My doctor did a CT scan and it said I had a small protusion at L2 L3 and also at L5 S1. He wanted to get a better look at it so he ordered a myelogram. That test was inconclusive and he simply told me that there was nothing surgically he could do for me. He didnt even offer a suggestion of what I should do. I felt abandoned, especially after he has been helping me for 5 years now.
I decided to call the
(edited to remove the name of the physicians office.)
Institute after family refered me to them. When I called for the appointment, they asked my history, and when I said I had a Spinal cord stimulator in me, they said they would not see me because of that. No other explanation. Crazy.
I am going to see another surgeon on the 12 of August. Hopefully he can help me.

john j lindenman

Red621
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Joined: 10/15/2013 - 12:50pm
HELP!!

I had a fantastic response to the temporary spinal cord stimulator.........then they implanted it permanently and i am still in so much pain......i've had a lot of re-calibrations from the rep with no improvement.........now my PM wants to refer me to a NS for a paddle.........has anyone had a similar response??

Rickilalas
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Joined: 06/07/2012 - 1:57am
scs

Red621
I asked and was given a lot of advice before I did have my SCS implant done.
In my opinion,my surgeons opinion and my pain doctors opinion we did a paddle because they are attached in a way that they have less chance of migration. If your trial went well your implant should be better. A couple of reason that change this are your leads were not placed in the perfect place for you or they have migrated ( moved ) from the right position.
Your doctor should try relocating them for better coverage before doing surgery to place a paddle. The paddle requires a small laminectomy. One small hint, laminectomys hurt for a few days to a week. They are really painful.
I would ask about moving the leads for better coverage. One eighth of a inch can make a difference in allowing the rep to program and cover your pain.
Good luck it most be frustrating when you had a good trial and now this. Don't give up yet.

Squirrel Creek
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Joined: 01/17/2014 - 8:59pm
Just joined- had SMS implanted 12-19-13

Had the trial from 12-11-13 to 12-19-13 when it was installed permanently. Had the paddle installed between the shoulders surgically. So it's now 1-17-14. Gonna change programs around next week and "fine tune". Are there times of improvement like a 6 month marker or 1 year marker. I am still "playing" with options to see what suits me best. L4-S1 are fused. Having ilium pain or pain that radiates out to the upper hips from center lower spine but also days from hip balls to upper hips. Like most I guess; I'm lost. Is Failed Back Syndrome a general term for we don't know? I LOVE MY JOB AND CAN'T WORK. I'm a Barber. At least up until about 5 years ago when I lost everything but my wife and family. She's been GREAT. Want better for my family. Any advice or suggestions appreciated. Also, been denied disability twice so far. Appealing now. I fall a lot. Can't stand or walk a lot. Again, any help appreciated. Using Allsup as disability rep..

Him dat give the bushy tail to da squirrel, give da bobtail to da rabbit.

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