Stimwave SCS implant

[painfre]

I have been to Stimwave PNS course few weeks ago. Not that impressed with Peripheral nerve stimulation.
But the spinal cord stimulator Implant/Permanent procedure seems to be much simpler than the devices from other companies. Anyone share their experience?

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[BobBarker]

Just put a normal system in. No one wants to walk around with a felt pad under their bra strap for the rest of their life. You still have to anchor the leads.

 

[Orin]

The minimal incision and lack of an IPG is neat. You will have to cut down to fascia. It's higher risk of migrating inward, so you'll have to knot it from doing that.

I do think about it for high risk surgical candidates where I'd like to cut the implanting time significantly, as it would probably be ~30-50% of a conventional implant with not having to coil leads, tunnel, or create/close an IPG pocket.

I do think about it for patients where I don't think I'll ever want to replace an internal battery but they'll live too long for a prime cell. I don't know how I would feel in private practice about the revenue loss as it removes the annuity of an IPG revision, but I don't have those pressures right now.

I haven't put one in for SCS as I can't talk patients into putting up with the external antenna in the back, though the PNS players are generally game since it's a lot easier to deal with an arm or leg band. The antenna/lead orientation are a bit unforgiving.

 

[callmeanesthesia]

What has been your experience with PNS? I’ve never done one but I joined an orthopedic practice and have lots of refractory knee pain after TKA. I’ve heard anecdotally that PNS can work well even for non-neuropathic pain, and I’d like to have somewhere to go after genicular RF.

 

[lobelsteve]

What has been your experience with PNS? I’ve never done one but I joined an orthopedic practice and have lots of refractory knee pain after TKA. I’ve heard anecdotally that PNS can work well even for non-neuropathic pain, and I’d like to have somewhere to go after genicular RF.

It may not work, but im sure it is profitable. Until complication or audit.

 

[SommeRiver]

What has been your experience with PNS? I’ve never done one but I joined an orthopedic practice and have lots of refractory knee pain after TKA. I’ve heard anecdotally that PNS can work well even for non-neuropathic pain, and I’d like to have somewhere to go after genicular RF.

DRG stim

 

[callmeanesthesia]

DRG stim

These are mostly nociceptive pain, not CRPS. Anyone try DRG for nociceptive pain and have good results? Couldn’t find anything about it on pubmed.

 

[SommeRiver]

These are mostly nociceptive pain, not CRPS. Anyone try DRG for nociceptive pain and have good results? Couldn’t find anything about it on pubmed.

Give it time and you'll see. There are a lot of ppl doing it and doing well.

Edit - There are always posters at NANS on this stuff.

A Multicenter, Retrospective Review of Chronic Post-surgical Knee Pain Treated with Targeted Spinal Cord Stimulation (SCS) | 18th Annual Meeting of the North American Neuromodulation Society

 

[Ducttape]

These are mostly nociceptive pain, not CRPS. Anyone try DRG for nociceptive pain and have good results? Couldn’t find anything about it on pubmed.

usually, not finding anything on pubmed is indicative in and of itself.


your post is case report. not worth much, maybe inducement for some poor sap to do a real study.

 

[SommeRiver]

usually, not finding anything on pubmed is indicative in and of itself.


your post is case report. not worth much, maybe inducement for some poor sap to do a real study.

I know, which is why I said give it time. There are ppl out there doing DRG for knee pain and having good results. Also a 12 to 1 trial to perm ratio in that case series isn't terrible.

 

[Ducttape]

I have found that given the "right" inducements, one can get pretty high trial to perm ratios.

it just becomes how honest the interventionalist wants to be.

 

[lobelsteve]

I know, which is why I said give it time. There are ppl out there doing DRG for knee pain and having good results. Also a 12 to 1 trial to perm ratio in that case series isn't terrible.

12 to 1 trial to perm ratio screams rape.

 

[SommeRiver]

12 to 1 trial to perm ratio screams rape.

Whoops! I wrote that wrong! Haha!

13 trials and 12 implants.

 

[Orin]

The money really isn't there in PNS, although the Stimwave platform reimburses the best.

The Bioness system is simple and works for more true mononeuralgias, but I don't see that very often. It is an easy win for post-stroke shoulder pain.

It's probably better to stick to cash/stem cells.