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would you have a fusion or a SCS if given the choice?

tknow1978ttknow1978 Posts: 30
edited 06/11/2012 - 7:44 AM in Spinal Cord Stimulation
I have been given the option to have a fusion or spinal cord stimulator if the conservative treatments I am doing now don't work. I was wondering if anyone who has had experience with both or either of these has any suggestions or personal experiences to share. What would be your preference if you had to do it again?


  • wasn't given a choice, as my back was incredibly unstable. It was mandatory to get my back secure through a 360 fusion. After that, I was left with permanent nerve damage (actually had the nerve pain from day one, but none of my 3 L5-S1 surgeries in 12 months alleviated the nerve pain.)

    I got my SCS in January, 2009 and have gotten much of my life back.

    Good luck!

  • maybe this would have been more appropriate in the surgery or spinal cord stimulator forum. not sure, but i don't know how to move a post. sorry.
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  • tknow1978 said:
    maybe this would have been more appropriate in the surgery or spinal cord stimulator forum. not sure, but i don't know how to move a post. sorry.
    Taken care of.
  • If given the choice between the two, I'd certainly go for having the mechanical issue dealt with first. Otherwise the SCS is more likely to fail or be far less effective in a very short time.

  • I agree with haglandc. While I do not have a spinal cord stimulator, I am currently considering that option and from the research I've done and conversations with my doctor it looks like unless the underlying mechanical issues are dealt with first the SCS tends to become less and less effective over time. SCS is indicated primarily for neuropathic pain, and if there is spinal instability you are most likely experiencing both nociceptive, mechanical pain as well as neuropathic pain. I'm not sure if your pain is primarily low back or leg, but it is also worth noting that while it is usually pretty easy for doctors to cover leg pain with a SCS, it can be difficult to get axial low back pain coverage (the research I have come across shows that at a 1-2 year follow-up about 50% of patients report satisfactory low back pain relief. Of course, you should talk to your doctor about these specifics in relation to your situation).

    I would definitely ask your doctor what he sees as far as long-term relief with a SCS if you decide against the fusion. You might specifically mention nociceptive versus neuropathic pain because he should be familiar with those terms and be able to explain it better. You might also ask about what he realistically expects as far as pain relief if you go with a fusion. Fusions are tough surgeries, but it may be worth it if there is a realistic shot at pain relief by stabilizing your back.

    I'd also encourage you to just read through the post on the SCS forum. There are really knowledgable people sharing their experiences, and for me I found just reading through the forum gave me a pretty good picture of both the positives and negatives of SCS.
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  • I agree with C SCS is for your last resort. If nothing else can be done them go for SCS.

  • You'll want to have the fusion first to stabilize your back, otherwise the stimulator will be doomed from the get go. I have had a 2 level fusion and stimulator. My stimulator works and helps me to manage a somewhat normal life, but if there was a chance I could live without it, I'd try the chance.

  • thanks thats some very good info. my back pain pails in comparison to the leg pain. I have a herniation affecting the transversing and exiting nerves at L4,5. My PM doc suggested the SCS, and my neuro surgeon suggests the fusion. I am actually having gastric bypass in 2 week s to see if that will help. My neurosurgeon wants me to lose weight so my surgery will have greater chance of success, as I have had 2 surgeries already with subsequent re-herniation. so fusion and SCS are next options if weight loss doesn't help enough.
  • With those above.
    You need to address the mechanical issue 1st. There is never any guarantee on any of this. You may be one of the lucky ones and find no need for the SCS once fused.

    You'll be much happier with not needing to charge and carry around a programmer all the time!

    Once you commit to an SCS it is pretty much a lifetime deal. You will have more surgery, no way to avoid it as sooner or later the ipg will need replaced, the leads even have a finite life, although with the ones they use now, I'm not sure they actually know what that life span is. Long, I hope.

    Even with all of the above, if the SCS works, it can be life altering. I always tend to advise that no matter what "others" say, if the SCS is offered as a last resort, try it. Percentages of success may be low for certain types of pain, but, you only need to be in that percentile! You won't know if you don't try.
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