I see a lot of misinformation here and want to help you clear a few things up.
Regarding leads-there is a difference. Perc leads are a good non invasive choice and will deliver the same stimulation as a paddle lead if implanted correctly. However Perc leads have a higher risk of migration, which could mean loss of stimulation in some cases. If this happens a lead revision would be done. With Paddle leads they stay in place much better because of the placement and sometimes yield better results because the paddle leads have even spaced contacts between all 16 of them. There is a chance with perc leads the two individual leads would be place too far apart not leading to as precise coverage.
Regarding the battery there is a HUGE difference. MDT battery will REQUIRE surgical intervention..ie a replacement of the battery after 3 over discharge. And it could happen before the 60 days like the other post said. With ANS one overdischarge will affect the battery and could lead to surgical intervention. Its important to know that you lose all programs everytime as well which means more time with the rep, even hours to get the programs you love back. Now to the good part. With Boston Scientific SCS you can deplete it as much as you want (obviously not recommended, but you could be non-compliant) and never lose programs or require a replacement because of the advanced technology. It may seem like not a big deal "I will never do this" however people forget to charge because of vactions, you leave the charger somewhere, illness or pregnancy. Why should you have to deal with worring about a device if you have the choice not too?
As far as programs, the number you get depends on the system you get (MDT, BSCI, ANS) and how good stimulation you get. They can be done at any time without surgical intervention you just call your rep from the company. A good rep will be there everystep of the way.
Doctors use normally what is most cost effective, MDT has been around a long time and can give discounts on products that ANS or BSC cant. However wouldnt you rather your insurance pay a little more for a BETTER product. More and more doctors are catching on that patient outcomes mean the most, if you hava a doc like this then he will use current control device, which tend to feel smoother than voltange base. This leaves ANS and BSC. Now BSC is the only company that can actually steer current by fractionalizing it, other comapnies have an on or off for each electrode. This really only makes one company stand out in my mind..BSC. Do your research and I think you will agree.
Hope this helps.
I have had the Advanced Bionics system for almost 4 years now. It features a rechargeable battery. If you go to each manufacturer's website they will show you actual photographs of each component of their system. That is also a good place to see the difference between the flat paddle leads and the percutaneous leads.
The Metronic system hold 4 programs. The hand held controller ($1,000 if you lose it - loss not covered by insurance) allows you to select a program and modify the intensity of the signal. The controller also allows you to turn the system off when not in use. The manufacturer's rep programs each of the 4 programs to your specific needs. For example, mine are; feet only - legs and feet - upper thigh area and hips - and finally all. The rep uses a computer to program the intensity, rate and duration of the signals or impulses. I recharge my system by using a small compact size recharger. Something similar to double stick tape is applied to the back of the recharger and you stick it to the skin covering the SCS (Spinal Cord Stimulator). A belt and poach are provided so that you can walk around while it is recharging. The more you use your system the more often you need to recharge it. According to the Medtronic rep you can leave the system run dead and no harm will happen. All you have to do is recharge it and it will be back and operating. Again, the Medtronic rep told me with normal daily use - the internal battery will last between 7 to 10 years.
I decided to have my SCS implanted in my abdomen rather than my hip because I spend time in a wheelchair and in bed. Other patients have told me the hip location was uncomfortable in wheelchairs.
The decision to use paddle leads is a serious one. Paddle leads must be surgically implanted by a neurosurgeon. This is a quote from the Mayo clinic pain site: In SCS, leads are placed in the epidural space near the spinal cord. The leads may be cylindrical or paddle shaped. The advantage of percutaneous leads is that they can be placed with a minimally invasive procedure. The disadvantage is that they may migrate over time and need to be repositioned. Paddle leads in the epidural space are more stable but require a minilaminectomy.
Rare neurodegenerative disease called “Multiple System Atrophy”. Wheelchair, O2, & Bipap, intrathecal pump, neurostimulator, dystonia, neuropathic pain, spasticity...etc..etc.
Post Edited (Stella Marie) : 5/12/2009 9:39:33 PM (GMT-6)
It depends on where you have had your previous surgeries and the resistance in the dural space. They only need to perform a lami in one spot, some patients have 7 or 8 back surgeries. A paddle might be better for you, but your PM will be able to better make that choice.