Spinal Cord Stimulator
Discussion
After all the stories in 'Prolapsed disc, had my op, what now?' here's an update on what's to happen.
Briefly, I slipped the disc at L5/S1 five years ago. The only decent painkilling I received was from dorsal root ganglion injections (nerve blocks), which reduced the pain by about 30% for 3 months each time.
Then, a microdiscectomy with laminotomy (Sept'08)and another laminotomy in June '09. A Failed Back Surgery Syndrome diagnosis ensued and now, I'm to have a Spinal Cord Stimulator (SCS) implanted. I just passed my pre-op assessment so it could be soon...nice to see the familiar faces at Royal Preston Hospital again.
Though ops are scary, I'm not all that nervous, I just hope the implant works. It's basically targeted TENS machine-type stimulation that's expected give 50 to 70% pain relief, turning the pain signal into parasthesia (tingling).
The gen on the Medtronic SCS is here, at http://www.medtronic.co.uk If interested, click on 'Neurostimulators - Pain Conditions' in 'Our Therapies'.
Briefly, I slipped the disc at L5/S1 five years ago. The only decent painkilling I received was from dorsal root ganglion injections (nerve blocks), which reduced the pain by about 30% for 3 months each time.
Then, a microdiscectomy with laminotomy (Sept'08)and another laminotomy in June '09. A Failed Back Surgery Syndrome diagnosis ensued and now, I'm to have a Spinal Cord Stimulator (SCS) implanted. I just passed my pre-op assessment so it could be soon...nice to see the familiar faces at Royal Preston Hospital again.
Though ops are scary, I'm not all that nervous, I just hope the implant works. It's basically targeted TENS machine-type stimulation that's expected give 50 to 70% pain relief, turning the pain signal into parasthesia (tingling).
The gen on the Medtronic SCS is here, at http://www.medtronic.co.uk If interested, click on 'Neurostimulators - Pain Conditions' in 'Our Therapies'.
Edited by davhill on Wednesday 5th May 20:58
A member of my family had this fitted 2 years ago. Seems to work well for him, although he has had to have it adjusted a bit. He had the operation done at Sheffield and the after-care has been very good. Still seems weird to see him using a remote control to change the settings!! Hope it goes well for you 
Good luck !
I think with the op you probably get to the stage that you just want relief, and anything in between is a means to an end.
This coming from the girl that was v nervous before the discectomy (as you know!)
Let us know how you get on, fingers crossed! Have they ever talked about disc replacement? Do you know when they consider disc replacement vs the stimulator?
I think with the op you probably get to the stage that you just want relief, and anything in between is a means to an end.
This coming from the girl that was v nervous before the discectomy (as you know!)
Let us know how you get on, fingers crossed! Have they ever talked about disc replacement? Do you know when they consider disc replacement vs the stimulator?
Yes, after 5 years of problems, I could use some relief! How are you now?
My duff disc is stable, so a fusion or disc replacement aren't necessary. In fact, the latter is a massive op, with access from the front, past all the pipework.
Given my scar-growing talents, everyone concerned recommends the SCS route.
My duff disc is stable, so a fusion or disc replacement aren't necessary. In fact, the latter is a massive op, with access from the front, past all the pipework.
Given my scar-growing talents, everyone concerned recommends the SCS route.
Yes, my surgeon initially suggested disc replacement (before he'd seen the MRI), because based on my symptoms he was expecting a lot more degeneration; I made the mistake of looking at the op on youtube! Scary stuff, so it was a relief to "just" have the discectomy. He has said, however, that a disc replacement may well be on the cards in a few years time (L4/5) 
I posted in the other thread but I'm doing "OK" - had a bit of a relapse the last couple of days, I suspect I overdid it Now got buttock pain again and "tailbone" soreness, and my left foot is still lazy and I scuff it occasionally.
I think I walked too far and probably been trying to do too much around the house, I just hope it's a temporary setback rather than anythig permanent - I think the fear of a relapse is worse than the pain sometimes.
Going to start doi some work from home next week (will be 4 weeks post op) - I think 2 or 3 x 40 minutes for the first week is hopefully what my boss will be ok with (I'm sure he will).
I posted in the other thread but I'm doing "OK" - had a bit of a relapse the last couple of days, I suspect I overdid it
Now got buttock pain again and "tailbone" soreness, and my left foot is still lazy and I scuff it occasionally.I think I walked too far and probably been trying to do too much around the house, I just hope it's a temporary setback rather than anythig permanent - I think the fear of a relapse is worse than the pain sometimes.
Going to start doi some work from home next week (will be 4 weeks post op) - I think 2 or 3 x 40 minutes for the first week is hopefully what my boss will be ok with (I'm sure he will).
L4/5 herniation causes slightly different problems to L5/S1 even though the 'mechanism' is the same. it sound to me like you have overdone things; I find the same even with my remaining problems. For example, I was obliged to do some carpet cleaning and I knew all about it the next day.
To complicate matters, the nucleus pulposus material is toxic to the nerve, so as well as mechanical pressure, you get a degree of 'poisoning' that must heal too.
The first surgeon described the affected portion of my sciatic nerve as 'bruised, inflamed and pinched' - she should know, she's seen it twice!
As regards continuing pain, that's an individual thing. In my case, scar tissue has grown and is putting pressure on the nerve; the displaced disk material is gone and there's plenty of room otherwise after two goes at taking away bone (from the lamina).
The good news for you is that not everyone grows internal scar material like I do. It's likely that the nerve root (probably L5 in your case) will complain for a while yet but will slowly get the idea and settle down. If you take care not to ask too much, too soon, you should find relief will be there. There can be a 'hangover' of pain signals but, as long as the damage has been fixed, properly, they'll stop over time. Remember that the pain signal is there to tell you something isn't right...it's naturally a touch over-enthusiastic in some areas to act as a damage-limitation thing. It's about survival!
dreamer75 said:
PS - what causes the pain now then, is it that the nerve was damaged by the scar tissue/initial disc problem, or is it the case that the nerve is still sending pain signals even though there's no physiological cause anymore?
Nerve damage, however caused, is slow to heal. When you have a herniation, the jelly-like inner part of the disc (the nucleus pulposus) physicially presses on a nerve...and we've all heard that expression, 'touching a nerve'. I call my sciatic pain the 3-foot toothache, which is a fairly accurate description. To complicate matters, the nucleus pulposus material is toxic to the nerve, so as well as mechanical pressure, you get a degree of 'poisoning' that must heal too.
The first surgeon described the affected portion of my sciatic nerve as 'bruised, inflamed and pinched' - she should know, she's seen it twice!
As regards continuing pain, that's an individual thing. In my case, scar tissue has grown and is putting pressure on the nerve; the displaced disk material is gone and there's plenty of room otherwise after two goes at taking away bone (from the lamina).
The good news for you is that not everyone grows internal scar material like I do. It's likely that the nerve root (probably L5 in your case) will complain for a while yet but will slowly get the idea and settle down. If you take care not to ask too much, too soon, you should find relief will be there. There can be a 'hangover' of pain signals but, as long as the damage has been fixed, properly, they'll stop over time. Remember that the pain signal is there to tell you something isn't right...it's naturally a touch over-enthusiastic in some areas to act as a damage-limitation thing. It's about survival!
So in your case it's either scar tissue, or nerve damage, or a sort of "nerve memory" (similar to a missing leg still hurting)...
I suppose time will tell, people keep telling me 3 weeks isn't long after a major op to expect to be better, but all the literature says after 4 weeks you should be back to work (dependent on your job) and driving, and after 6 weeks back doing most things.
I just don't feel that's realistic!
I suppose time will tell, people keep telling me 3 weeks isn't long after a major op to expect to be better, but all the literature says after 4 weeks you should be back to work (dependent on your job) and driving, and after 6 weeks back doing most things.
I just don't feel that's realistic!
Wheelrepairit said:
Im on the programme for 1 of these babys to be fitted once ive passed all the tests and psycology reports.
Its passing them that seems to be the problem
Bookmarked thread, keep me updated folks on how you getting on.
Pete
The pain management consultant told me an interesting story. In the early days of SCS implants, a very keen doc fitted them to a wardful of chronic pain patients. A fairly high percentage (over 30%) apparently had no improvement at all. The psychology of this was that they were so accustomed to being in pain, they continued to be in pain regardless of the SCS implants.Its passing them that seems to be the problem
Bookmarked thread, keep me updated folks on how you getting on.
Pete
I can understand this, and I reckon the length of time you've been in pain is psychologically significant. I also have an MSc degree in...yes, psychology!
Another point worth noting. The sister at the hosp told me that this op is the most exepnsive they do. My research on the 'net has shown the following *average* prices...
Spinal cord stimulator unit £9,750
Standard leads/electrodes £1,100
The sister also pointed out that the cost of keeping a patient in high-end painkillers permanently is high. Then again, the consultant who's going to wire me up said the op, hardware included, is a £20,000 task.
Seems to me that part of the equation is the size of the Primary Care Trust's budget. I'm hoping for a 'Restore' unit, that is rechargable from outside so there's no need for another op for battery changing. That's still more fingers crossed.
As ever, will keep you posted.
Good luck with the implant. Lots of people are genuinely transformed by this amazing therapy. You might be interested that Medtronic is in the process of launching the Restore Sensor SCS. This can automatically regulate it's output depending on your body position. No idea whether this might be better for you than what's out there at the moment but it might be worth asking.
http://finance.yahoo.com/news/Medtronic-Announces-...
http://finance.yahoo.com/news/Medtronic-Announces-...
Cross your fingers for me - the last 2 days have seen my left leg fizzing (as if there's a bottle of fizzy water in it) and itching, I'm hoping it's weird sensations from healing nerves other than anything sinister!
Do you know when you are having the op (apologies if I've missed it higher up the thread)?
Do you know when you are having the op (apologies if I've missed it higher up the thread)?
Deliveredenergy said:
Good luck with the implant. Lots of people are genuinely transformed by this amazing therapy. You might be interested that Medtronic is in the process of launching the Restore Sensor SCS. This can automatically regulate it's output depending on your body position. No idea whether this might be better for you than what's out there at the moment but it might be worth asking.
http://finance.yahoo.com/news/Medtronic-Announces-...
Thanks for the info about this interesting development. I know that the devices I'm liable to be offered have a good record. My main preference would be for the rechargeable variety (all of these are called 'Restore' so this new one clearly has this feature). http://finance.yahoo.com/news/Medtronic-Announces-...
I've found out that, at medium power, the larger of the two pulse generators is charged monthly, the smaller one needs fortnightly charging. In each case, a charger unit on a belt pumps up the power from outside the body.
More importantly to me, the non-rechargable devices can run for up to 5 years but need careful power management. They could last for a much shorter time and battery replacement means surgery...again. Conversely, the Restore units are expected to run for 9 years without maintenance.
Having read the piece at the link you sent, it looks like I'll be getting wired long before the position-sensing alternative is available. However, I'll be speaking to the rep from Meditronic so I can but ask.
dreamer75 said:
Cross your fingers for me - the last 2 days have seen my left leg fizzing (as if there's a bottle of fizzy water in it) and itching, I'm hoping it's weird sensations from healing nerves other than anything sinister!
Do you know when you are having the op (apologies if I've missed it higher up the thread)?
I think you'll find this comforting. As you know, my sciatic nerve is affected, and I have experienced the following...Do you know when you are having the op (apologies if I've missed it higher up the thread)?
The nerve's track is mapped by the feeling that it's a length of barbed wire connected to the mains. Sometimes, it feels taut, like a red hot piece of piano wire.
Sometimes, I feel like a blowlamp flame is being played up and down the skin of my calf.
Other times, I feel like I've been smashed in the ankle with a baseball bat.
Not too comforting, I know, but the point is that these things are products of the same nerve, under the same pressure. An area innervated by a particular nerve acting in its afferent capacity (taking signals from the site of the feeling to the brain) can offer weird feelings as the nerve heals. I reckon this is what you're experiencing...it'll go in time.
I passed my pre-op assessment last Tuesday (4th May) and had already done the MRSA swab tests. At Preston (or anywhere else) it's normal for the operation to be carried out up to three weeks after the pre-op. In theory, I should have the op by the 25th may at the latest. I've also opted for a cancellation at short notice so it could be sooner.
I'll keep you posted about the date I'm given. If folk are interested, I can web surf and post using my smartphone, so I could transmit from the hospital. This would give me a welcome distraction!
Good luck with your upcoming op, I'm sure it'll be a success.
I'm sure you've tried pretty well everything for pain management, and it's a bit late in the day but here's a couple of ideas.
Bromelain is a natural anti-inflammatory, as is Ginger. Bromelain is a pineapple derivative and has no real side effects, unlike most drugs. Just takes a % off it, but worthwhile. Healthspan is one of several sources.
You will prob have tried Diclophenic (Voltarol) which is too harsh on the tum for a lot of people. But it can be applied, shall we say, from the other direction, which is close to the area required. It's also available in cream. Not going to fix it all, but easy to apply, no ill effects etc.
Arnica is a similar gel which can be effective to some degree. I don't know what the Arnica tablets are like.
If your ankle is lazy (I presume you mean a slight tendency to drop) you might think about lifting it slightly so it doesn't affect your gait and cause lower back pain. You can buy physio supports to all degress but for a little support which doesn't take over, Scholl ankle supports are worth a try. Just elasticated cotton, does minimal work, which might be all you need.
Anyway, good luck with it, and let us know how you get on.
I'm sure you've tried pretty well everything for pain management, and it's a bit late in the day but here's a couple of ideas.
Bromelain is a natural anti-inflammatory, as is Ginger. Bromelain is a pineapple derivative and has no real side effects, unlike most drugs. Just takes a % off it, but worthwhile. Healthspan is one of several sources.
You will prob have tried Diclophenic (Voltarol) which is too harsh on the tum for a lot of people. But it can be applied, shall we say, from the other direction, which is close to the area required. It's also available in cream. Not going to fix it all, but easy to apply, no ill effects etc.
Arnica is a similar gel which can be effective to some degree. I don't know what the Arnica tablets are like.
If your ankle is lazy (I presume you mean a slight tendency to drop) you might think about lifting it slightly so it doesn't affect your gait and cause lower back pain. You can buy physio supports to all degress but for a little support which doesn't take over, Scholl ankle supports are worth a try. Just elasticated cotton, does minimal work, which might be all you need.
Anyway, good luck with it, and let us know how you get on.
Im just recovering after my second discectomy in 3 years - same place each time - L4/5 L5/S1 - interesting reading this thread - my doc/surgeon has never said anything to me about SCS or disc replacement. Do any of you think that disc replacement may be on the cards in a few years ? I was very disappointed with my surgeon - communication was not his strong point. When he came around the morning after the op I was still out of it and my g/f wasn't there to ask him any questions - he just said there wasn't much disc left !! Not really sure what that means.
Anyway - I wish you luck with your operation - please keep us updated on your progress.
All the best.
Anyway - I wish you luck with your operation - please keep us updated on your progress.
All the best.
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