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Thread: Spinal Cord Stimulator With a Paddle Lead

  1. #1

    Question Spinal Cord Stimulator With a Paddle Lead

    Hi, everyone. I am a complete T10 paraplegic (12.5 years) and I currently have a SCS, one that allows MRIs, with a single lead placed in the spinal canal for severe pain in my right hip. While the SCS does help a ton, my pain has gotten much, much worse in the 2.5 years that I've had it in and my pain management doctor cannot pinpoint the cause of the pain. I've had xrays, CT scans, and countless other procedures in trying to figure it out. A hip and knee specialist that my PM doctor referred me to said that an MRI is the best bet to figuring out the cause of the pain but there is a strong impedance in the bottom contact. I am unable to have the MRI because of this, so I convinced my PM doctor that we should remove the current SCS so I can finally get the MRI and then put it back in ASAP. It was then that he mentioned a paddle lead would be the best bet to get better pain relief. The problem is that I have a large amount of scar tissue in the T9-T10 area. The current lead wasn't placed where he wanted because of this, so he told me that a neurosurgeon would have to remove the scar tissue and then place the paddle lead where it needs to be. I naively thought that the process wouldn't be too bad, but I just did some research and saw that a laminectomy or laminotomy would be required for a paddle lead to be placed. I went from not worrying too much about the surgery to now having so much anxiety that I'm shaking. I know that we are at a much, much higher risk of heterotopic ossification, bursitis, osteopenia/osteoporosis, arthritis, etc After seeing my xrays and CT scans, the hip specialist said that while I will eventually have to have 2 hip replacements, which is quite ironic, I won't need them for quite some time. I guess my questions are:

    Has anyone had regular leads and switched to paddle leads? If so, how much better was the pain relief? If not going from regular leads to paddle leads, how much relief did you get from a paddle lead?

    As I'm sure we all know, we can handle a bit more pain than the average person since so many of us are in pain every second of the day. I know everyone is different but how long was your recovery and how bad was it?


    I apologize for the long paragraph, but I wanted to give as much information as I could to make any reply easier on you all. I'm just sort of panicking after reading about the laminectomy/laminotomy and recovery things. The only things that I've found about paddle leads are scientific studies and people posting about how much agony the recovery was. I'd much rather have a conversation with those that have had the procedure or have been around someone that has.

    Thank you your time and have a great day!

  2. #2
    I had a 16 pin paddle put in with my SCS about three years ago, around T3-4. I'm a T6 complete so they had to put it above my injury level due to scar tissue as well. I think I was out for 3-4 weeks during the recovery, but I may be thinking about when I had my hardware removed, so it may have been less than that. It was not fun, but I had to at least give it a chance to see if the SCS would help. Unfortunately for me it didn't and I can't compare regular leads with paddles since I never had regular ones. Not sure that was particularly helpful, sorry.

  3. #3
    Quote Originally Posted by Brad09 View Post
    I had a 16 pin paddle put in with my SCS about three years ago, around T3-4. I'm a T6 complete so they had to put it above my injury level due to scar tissue as well. I think I was out for 3-4 weeks during the recovery, but I may be thinking about when I had my hardware removed, so it may have been less than that. It was not fun, but I had to at least give it a chance to see if the SCS would help. Unfortunately for me it didn't and I can't compare regular leads with paddles since I never had regular ones. Not sure that was particularly helpful, sorry.
    I appreciate the response. They might end up putting the paddle above the scar tissue, but I have yet to meet with the neurosurgeon so time will tell.

    Was removing the scar tissue and placing the paddle where the tissue was not an option for you? That's a bummer, man. I'm sorry it didn't work out for you. It's amazing that some people will experience considerable pain relief while others do not. If you don't mind me asking, was there another procedure or something that they went with after it was determined that the SCS didn't work?

    Before getting the IV to remove the current system, the PM doctor came in and I started asking questions about the laminectomy and whatnot and he said that he wanted to try and get in touch with the neurosurgeon before doing anything. He mentioned that the worst case scenario would be insurance allows for the removal of the stimulator but might now pay to have a different one put in since the removal was being billed as a removal instead of a revision. He now wants me to have a CT myelogram with dye on both my thoracic and lumbar spine since the neurosurgeon said that will be enough to tell him if I need to have a laminectomy. I've been asking for about 8 months if there was something else that we could do after the neurosurgeon's receptionists told me that I had to have the MRI before seeing him. It's unbelievably frustrating when I think back to the last 8 months and we could've already done the myelogram and surgery already. I hate the systems that we have to deal with.

  4. #4
    Quote Originally Posted by WonderDerek View Post
    I appreciate the response. They might end up putting the paddle above the scar tissue, but I have yet to meet with the neurosurgeon so time will tell.

    Was removing the scar tissue and placing the paddle where the tissue was not an option for you? That's a bummer, man. I'm sorry it didn't work out for you. It's amazing that some people will experience considerable pain relief while others do not. If you don't mind me asking, was there another procedure or something that they went with after it was determined that the SCS didn't work?

    Before getting the IV to remove the current system, the PM doctor came in and I started asking questions about the laminectomy and whatnot and he said that he wanted to try and get in touch with the neurosurgeon before doing anything. He mentioned that the worst case scenario would be insurance allows for the removal of the stimulator but might now pay to have a different one put in since the removal was being billed as a removal instead of a revision. He now wants me to have a CT myelogram with dye on both my thoracic and lumbar spine since the neurosurgeon said that will be enough to tell him if I need to have a laminectomy. I've been asking for about 8 months if there was something else that we could do after the neurosurgeon's receptionists told me that I had to have the MRI before seeing him. It's unbelievably frustrating when I think back to the last 8 months and we could've already done the myelogram and surgery already. I hate the systems that we have to deal with.
    I was never given the option to remove the scar tissue. I was under the impression the paddle needed to go above my injury level anyway in order to be effective. I haven't had anything else done after the SCS didn't work. I've basically tried every other option available, so that was my last shot. I eventually got off all my pain meds (they weren't helping either) and I just deal with it. Between work and having two kids under 3, I stay busy and distracted enough to manage the pain.

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