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Medtronics SCS vs Boston Scientific SCS

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124

Comments

  • Im glad for you....Do you know where they are going in? It's been a long time, hasn't it? So 2 battery's?
  • Yes it's been a long time. I could swear I had another post that isn't showing now.
    Well last week I was to get a date. Didn't get a call until Friday and office help had it messed up for a cervical stim not a second Lumbar unit. I will get a cervical unit later when and if I need another cervical survey. I say that like I won't need that. Crystal ball says it's in the future. Anyway Monday they have to set it up with the surgeon who isn't in on Friday to clear it up. So I hope I get a date tomorrow but then I see it's a holiday so maybe it will be Tuesday.
    I am not to worried Friday afternoon I had a PM appointment for my three injections and he said he talked with the surgeon and everything is set up. Time will tell.

    I decided that the best way for me to go is a second unit separate from the first. My current unit covers everything but my ankle real well and I don't want to chance losing any of that coverage with a change of everything. So keep the old unit and add a second one that will have extra Ports available for later use if needed. This will give me two paddles with sixteen contacts each and the extra Ports to add more later if needed and it's even possible to use the second unit for a cervical paddle later two.
    Then just for fun and a few other reasons I want a BS unit this time so I will have two separate remotes and two different chargers. It will be more for me to deal with but I do feel it's the right thing to do at this time. My medtronics unit has and is working great. It is not a issue of the unit but a issue of where a second paddle needs to be placed.
    I feel both companies have a great product. I also feel it's the skill of the surgeon and the programming rep that makes these a success or a failed treatment.

    One funny thing the other day. I use a training university which has a fantastic spine department. Before you see the surgeon you see a MD that is in or trying to get into the spine program which I believe is a extra three years of education. So anyway here sit's this MD looking at my full body scan digital xray and he ask have I had any surgery before???
    Sorry could not let that get by I said I don't know for sure but I thought maybe I did because I could see one plate with six screws two short rods with three screws each two long rods with six extra long screws a battery, a circuit board, wire leads and a paddle.I think they were added at some point. Right there on the screen. Wish I could have remembered to say hey here's your sign!!!! Got to have fun when you can right. And they say no question is a dumb question.
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  • has a lot to learn. Im sorry it's like coming to this site and asking if anybody knows about SCS????? You sound good Ricki, things will start to move for you.......
  • Two days ago I had the second unit implanted. They had a cancellation called me and asked if I could be ready with just a few days notice. My answer was yes and now it's in.
    Still major pain from surgery but ankle pain has been taken care of. My foot does not feel like it's in a meat grinder anymore. This will be my best Thanksgiving ever !!!

    I wish for everyone of you to have a great Thanksgiving too !!
    More later still hard to think much.

    Rick

  • I am so pleased for you!
    Happy Thanksgiving :-)
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  • TerriPTTerriP Posts: 301
    edited 11/29/2013 - 9:31 AM
    it's on and programed Already? That is fantastic!
  • RickilalasRRickilalas Posts: 559
    edited 11/30/2013 - 10:09 PM
    Hi
    Ok for anyone following this thread on Tuesday I had a Boston Scientific SCS implanted.
    Surgery went well took.a.couple of extra hours because of scar tissue and of course that added to recovery room time also.
    This was done has a outpatient surgery. The unit was programmed in the OR and tested before sending me to recovery. After the trip home and getting all set up in bed I turned it on.
    With both the new Boston unit and my already implanted medtronics unit I was pain free from all of my prior pain but the surgery pain was terrible and has been until today..
    It took four to five days to get over very bad surgery pain which is now down to about a 7 if I don't move wrong. My left ankle no longer feels like it's in a meat grinder unless I turn off the BS unit. In less then thirty mins the pain returns but just turning the BS unit back on shuts the pain down right away.
    I am on more pain meds right now because of the surgery and will start weaning down on them in about two weeks. I will have much more to write about in the future.
    This is going to be nice to compare the units. Right now it takes both units to take care of all of my pain from the waist down has long has I don't do much.
    We will see what the future holds.

    Talk with you later
    Thanks Rick

  • Things are sounding very hopeful for you.
    I really pray that you will at last have your pain controlled and then you can start to plan your life again. :-)
  • Hello.Everyone
    Thanksgiving week I had a Boston Scientific SCS implanted with a paddle at a lower level then my Medtronics unit. Using both units I have fantastic coverage. I am still using the first programs loaded in the OR by the BS rep. If this is new to you there years ago I had a medtronics unit placed with a paddle which was placed higher then the normal.sweet spot for the coverage we needed. I can explained that to anyone that needs to know why later.
    Over time a new left ankle pain started and quickly became a major pain. Felt like a chain saw was cutting my foot off all the time. Meds did not touch it. ESIs three of them every two weeks did help but we all know that's not a good idea. Pain management doctor started with the idea if removing my medtronics unit and replacing with a BS unit because it can handle two 16 contact paddles. Myself and later my surgeon was against doing that anyway. We did.decide to try a trial with a BS unit to see if it would help. My insurance declined it and we fought for awhile. The ESIs ended up costing more then a trial anyway. Just can't see the logic sometimes. I had medicare coming up so we had to wait a few months. Once medicare was unplaced and a medical gap policy to cover the twenty percent we did a trial with a BS. I slept for 14 hours the first night. That meant it was a success right away.
    Then we had to convince my spine surgeon to do it. That took a few weeks and it was done.
    At first the trial had issues because of scar tissues and only one perc line was able to get close to the area we needed. During the 45 min implant the scar tissue from a previous surgery caused enough problems the surgery took about three hours and the could not get the paddle placed on the cord in the middle. It had to be placed at a angle on the left side which worked great for me because the left side was the issue. Thank God we did not remove the medtronics unit. Do not fix something that us not broken. Remember that.
    With medtronics implant the woke me up in the OR and did programs to check my coverage.
    With the BS unit they brought me awake some.but I knew none if it and made four programs that did work with the paddle in the spot it was at.. They turned it off and finished the surgery.
    In recovery pain meds had a very hard time covering the surgery pain and when the surgery pain was covered my ankle pain was still terrible. The BS rep gave my Mom and Sis the remote and paper work while I was in recovery. I went home that night with mild surgical pain and still major ankle pain. At home I turned the new BS on and wow ankle pain was shut down that fast.

    Surgery was hard to recover from and when I started feeling better I got sick. Don't know if it was meds or what maybe even the flu. Then for awhile I could not keep anything down including pain meds. Thank God I was on a patch and got some help from that.

    Tomorrow will be four weeks and I am happy to say I feel great. I can see no need for ESIs at this time. I have cut back a lot on my pain meds and I see my Pain Doctor on Jan first yes he is working and we will go over my whole med.program and start weaning down more of my meds. This is working so well. I do have to stress I need both units they cover different areas and I use them together. After some scaring in I will have the BS reprogrammed it has a few settings that get to high into the organs which doesn't feel so good. A adjustment will take care of that. My New Years is going to be so much better. Better then I had hoped for.
    If any one has questions I will do my best to get back to you. I was gone for awhile but should be here now.
    Between pain and being sick I did not do much of anything.

    I hope everyone has a Merry Christmas And a Great New Years

    Rick
  • waltfwaltf Austin, TXPosts: 19
    Glad that this has all worked out for you Rick!

    I had a Boston Scientific unit implanted back in June 2013 (about 6 months ago).

    When my PM doctor first suggested a SCS he gave me a St. Jude brochure. Being an Electrical Engineer (EE) I then did my own research and compared the pros and cons of the three major companies offering SCS systems in the US: Medtronics, St. Jude and Boston Scientific.

    The first thing of note: the Medtronic uses a constant Voltage source while SJ and BS use a constant Current. What is the difference and why should you care? It all comes down to what is called (in engineering) 'Ohms Law':
    V = R * I (V =Voltage, R = Resistance, I = Current). The V and I in that equation come from the stimulator while the R (resistance, also called impedance) comes from the leads, paddles and YOU the patient. This impedance can change over time as scar tissue forms around the lead contacts.
    So, what does that mean? In that formula above, for a Medtronics unit, the V is constant so as the R changes over time the I is also going to change and this is what your body (nerves) feel, the 'I' or the electrical Current flow. So, the stimulation level, given a set program (i.e. set 'V') will/could change over time.
    What about SJ and BS with a constant Current source? Well, lets adjust that formula around so that it is solved for I:
    I = V / R
    Now, when the I stays constant and the R (impedance) changes the Voltage will also change. What's the big deal? The fact that the I stays constant - like I said earlier it is the 'I' that you feel.

    Ok, since I am an EE, I liked the SJ and BS better than Medtronics (Medtronics is still a great unit and works fine, just maybe needs a little more programming as the 'scarring in' takes place).
    Now between the SJ and BS units what is the big difference? Well one thing (at least with today's models) is that the the BS unit can support 32 contacts (as Rick mentioned) while the SJ unit supports 16. But the other BIG difference is that the BS has SEPARATE current sources per channel while the SJ shares a single current source.
    What does that mean?
    Ok, take the SJ unit first - We start of (with a single current source) supplying some amount of current, this current now gets 'split' to flow down the multiple leads and into the paddles. Think of a big pipe coming into your house with water and then that pipe connects to a bunch of smaller pipes to bring water to all of your sinks. Now, in the SJ unit, if ALL the leads / contacts that are being used (i.e. turned on by programmer) have the EXACT same resistance (impedance) then the current flow is split evenly among all the leads and the stimulation level is equal for all contacts. Think of that house and water and all the pipes are the same length and diameter, all the faucets on the sinks are the same and they are all opened up the same amount, water coming out of each should be equal. Now, let us assume that one (or more) of the leads / contacts has a DIFFERENT resistance / impedance because of a different amount of scar tissue, say that lead has a higher resistance. Well, the current flow is now going to be less in that lead / contacts (less stimulation) and slightly higher in all the rest. Huh? Think about the house again BUT this time turn the faucet on one sink off about half way, what happens? That sink's flow decreases and all the other slightly increase.

    Now lets discuss the BS unit with SEPARATE current sources for each lead / contact. Now, when the resistance / impedance for a single contact changes it doesn't matter as there is a single current source for that lead / contact and it has a CONSTANT current ALL IT's OWN (doesn't 'share' the current with any other lead). Using our house and water analogy this would be like having a separate well and water pump connected to each sink. Now adjusting one sink does not affect the other sinks and even when I turn off a faucet a little on one sink the water pump for that sink will increase its pressure to make sure the water flows at the same rate (i.e. constant current == constant water flow) resulting in no change to the water flowing at any sink.

    So, because the BS unit has a current source for each channel it can provide you with a stable, constant stimulation pattern (at a given program or settings) regardless of differences between the impedance of each lead and contact.

    When I presented all this to my PM doctor he said that whenever he has a patient that is an engineer they come to this same conclusion and request a Boston Scientific unit. Also, when at the trial, my PM doctor told this to the BS rep and we then talked about all of this before the operation. The rep also told me how he had worked for all three companies and now ended up at BS because he liked their product the best. After the trial unit was 'installed' (taped the unit to my back) the BS rep had me do the programming, same with after the final unit was implanted,

    I have 3 basic 'programs' that we set up - these differ in which leads and contacts are enabled (turned on). Now I can take any of these 3 programs and copy it into a new setting (my unit has 16 programs) and then adjust the frequency, pulse width and amplitude and save that setting. I only had to see the BS rep one time after my implant to get these 3 basic programs 'dialed in' to my liking and now I can create and change various setting (the other 13 setting locations) as I see fit.
    I only imagine I would have to go back to see the BS rep is if I needed to turn on or off some of the contacts because of changes over time, like a lead migrating.

    Oh, one other thing I really like about the BS unit is the recharging: The 'charger' is a small unit that, when not recharging me, sits in its cradle (plugged in to power outlet) and charges its internal battery. Then when I need to charge that little unit comes off its cradle and goes into a pouch on a belt, press the 'power' button (charging unit starts beeping, an alignment beep) and you position the belt so that the beeping stops (and then velcro the belt tightly). Now you are free to walk around, etc, while you charge (usually takes me about 3 to 4 hours once a week to charge). This is very convenient as I do not have to be 'plugged in' as I charge. Once I am fully charged the unit beeps (different rate than 'alignment' beeps) to let me know and I take the belt off, remove the unit and place it back on its charging cradle so that it is ready for the next time I need to 'refill'.

    In conclusion I would like to say that any of the units on the market will work quite well, this is just my opinion and the choice of unit may be different for different people (your mileage may vary...).

    -Walt
    L5-S1 Discectomy
    L4-L5 Discectomy (four times)
    L4-L5 TLIF Fusion
    L3-L4 Posterolateral Fusion
    Revision L4-L5 Posterolateral Fusion
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