Spinal Cord Stimulation Can Help Some Long
A May 2022 study from a team of European researchers analyzed retrospectively the long-term outcomes of spinal cord stimulation treatment on predominant radicular pain. At an average follow-up of 10.6 years, 78.5% of the patients were satisfied with the treatment outcome, with a significant pain reduction of an average three points on a Numeric Rating Scale.
Spinal Cord Stimulator Settlement
If you need a spinal cord stimulator, it means you will have a lifetime of medical upkeep and surgeries in your future.
This means high costs, and even higher physical pain and recovery time as a spinal cord stimulator battery needs to be changed every few years.
In this article you will learn about:
What is a spinal cord stimulator
What affects your spinal cord stimulator car accident settlement
Average settlement values in spinal cord stimulator lawsuits
Spinal cord stimulator disability ratings
More detail on these topics and more can be found be scrolling down below.
Who Is A Candidate
An evaluation of your physical condition, medication regime, and pain history will determine whether your goals of pain management are appropriate for SCS. A neurosurgeon, physiatrist, or pain specialist will review all previous treatments and surgeries. Because chronic pain also has emotional effects, a psychologist will assess your condition to maximize the probability of a successful outcome.
Patients selected for SCS usually have had chronic debilitating pain for more than 3 months in the lower back, leg , or arm. They also typically have had one or more spinal surgeries.
You may be a candidate for SCS if :
- Conservative therapies have failed.
- You would not benefit from additional surgery.
- The pain is caused by a correctable problem and should be fixed.
- You do not want further surgery because of the risks or long recovery. Sometimes SCS may be chosen over a large, complex spine surgery.
- You do not have untreated depression or drug addiction these should be treated prior to having a SCS.
- You have no medical conditions that would keep you from undergoing implantation.
- You have had a successful SCS trial.
SCS works better in the earlier stages of a chronic condition, before a cycle of pain-suffering-disability-pain is established.
An SCS can help lessen chronic pain caused by:
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My Spinal Cord Stimulator Did Not Help
A November 2022 study lead by doctors at the University of California, San Francisco School of Medicine provided long-term follow-up outcomes in patients spinal cord stimulators and compared these outcomes to conventional medical management. This included: pharmacologic and nonpharmacologic pain interventions . The average patient in this study was 63 years old. Men accounted for 41% of the study group, women 59% of the study group.
Findings:
- During the first 12 months, patients treated with SCSs had higher odds of chronic opioid use compared with patients treated with conventional medical management but lower odds of epidural and facet corticosteroid injections, radiofrequency ablation, and spine surgery
- During months 13 to 24, there was no significant difference in chronic opioid use, epidural and facet corticosteroid injections, radiofrequency ablation, or spine surgery between SCS use and conventional medical management.
- Overall, 226 of 1260 patients treated with SCS experienced SCS-related complications within 2 years, and 279 of 1260 patients had device revisions and/or removals, which were not always for complications.
When a patient comes in with a history of Spinal Cord Stimulation or SCS implant without satisfying results, they will usually tell us a similar story to other patients we have seen:
I am not a candidate for more surgery. I guess the damage is done.
Radiculopathy pain
It just didnt help
Spinal Cord Stimulator Insertion Costs Are Recoverable In Settlements
The cost and maintenance of the spinal cord stimulator adds to the compensation values that you will likely get.
The procedure itself costs anywhere from $5,000-$12,000, but this is just the average of a one-time initial cost for those with health insurance. Without health insurance this one time cost balloons up to $19,000-$47,000.
If you are in a major metropolitan area like Los Angeles or Washington, D.C., those costs can extend beyond $75,000.
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Are There Complications That Can Come From A Spinal Cord Stimulator
Yes, there are many complications that can come from a spinal cord stimulator surgery. The spinal cord is a delicate part of the body and even the smallest disturbances can have a severely negative impact on your well-being. The complications can include bruising, numbness, paralysis, and pain just to name a few complications.
Hcpcs Codes Covered If Selection Criteria Are Met:
A4290 Sacral nerve stimulation test lead, each C1767 Receiver and/or transmitter, neurostimulator C1820 Generator, neurostimulator , non high-frequency with rechargeable battery and charging system C1822 Generator, neurostimulator , high frequency, with rechargeable battery and charging system C1883 Adaptor/extension, pacing lead or neurostimulator lead E0745 Neuromuscular stimulator, electronic shock unit L8679 Implantable neurostimulator, pulse generator, any type L8680 Implantable neurostimulator electrode, each L8681 Patient programmer for use with implantable programmable neurostimulator pulse generator, replacement only L8682 Radiofrequency transmitter for use with implantable neurostimulator radiofrequency receiver L8684 Radiofrequency transmitter for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement L8685 Implantable neurostimulator pulse generator, single array, rechargeable, includes extension L8686 Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension L8687 Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension L8688 Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension L8689 External recharging system for battery for use with implantable neurostimulator, replacement only L8695 External recharging system for battery for use with implantable neurostimulator, replacement only
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Which Pain Conditions Can Be Treated With A Spinal Cord Stimulator
A number of conditions cause pain that is non-responsive to traditional pain treatments. In these cases, spinal cord stimulation may provide an exceptional level of pain relief and may allow patients to reduce the amount of pain medication they need to manage their symptoms.
The conditions have been successfully treated with spinal cord stimulators:
Failed Back Surgery Syndrome.FBSS is not actually a syndrome. Instead, itsa collection of symptomsexperienced by individuals who have undergone back surgery that wasnt successful3. Failed Back Surgery Syndrome causes persistent, new or worsening pain following back surgery. This pain often results from the buildup of scar tissue around spinal nerves, recurrent disc herniation, and errors by surgeons. Pain caused by FBSS may not respond to traditional pain treatments.
Neuropathy.Neuropathy isa painful conditioncaused by damage to nerve tissues. When a nerve is damaged, it can produce an abnormal pain sensation, even when there is no painful stimuli4. Neuropathy symptoms include numbness, muscle weakness, tingling, a feeling of pins and needles, and general pain in the affected areas. Neuropathy commonly occurs in people with diabetes or HIV or in those who are undergoing chemotherapy treatment. It is also found in people who drink heavily or those working in professions that require repeated physical movements.
How Do Spinal Cord Stimulators Work
An SCS typically consists of several parts:
- Stimulator: a battery-powered device surgically implanted in your spine to generate electrical pulses
- Leads: thin wires connected to the stimulator that run through your spinal canal, delivering pulses to the spinal cord
- Remote control: a handheld device that helps you control the spinal cord stimulator and adjust its settings
Your doctors and other professionals will program your SCS to target your specific condition and symptoms, using specific patterns of electrical pulses of varying frequency and strength to address your pain.
Spinal cord stimulators have become increasingly sophisticated. Today, some devices are rechargeable and can even sense when youre sitting or lying down and will change your program based on your position and other factors.
A spinal cord stimulator, however, will not stop or cure your chronic back pain. Instead, it changes how your brain perceives the pain. So instead of feeling an excruciating pain that shoots down your leg, you might feel milder pain combined with numbness and tingling . Doctors consider a spinal cord stimulator successful if it reduces your back pain by 5070%. However, SCS does not work for everyoneand some people decide to remove their stimulators due to negative side effects or poor pain control.
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The Need For Spinal Cord Stimulators
When you are in an accident you can suffer multiple injuries like whiplash, headaches, neck pain, arm pain, back pain, leg pain, or spinal and brain injuries.
This can happen in both minor and major accidents, including in car accidents and workers comp claim related accidents.
Certain injuries, like spinal injuries, can take a long time to heal and in some cases, never fully heal, leading to chronic pain which can be debilitating for your daily life and activities, making everything from eating to sitting and even laying down painful activities.
Chronic pain can wear a person down leading to other chronic health problems such as depression, weight gain, and reliance on medications which all have their own side effects.
If your chronic pain comes from a spinal injury, and does not go away with other less intrusive treatments that have been tried so far, a final solution may be a spinal cord stimulator.
Failed Spinal Cord Stimulation Syndrome
In this paper the researchers refer to salvage or rescue procedures to make the implants work better.
A January 2022 study in the Journal of Clinical Medicine writes: While paresthesia-based Spinal Cord Stimulation has been proven effective as a treatment for chronic neuropathic pain, its initial benefits may lead to the development of Spinal Cord Stimulation Syndrome. The researchers define this as a lessening beneficial effect of treatment over time. They also write that the main goal of study was to investigate salvage procedures, through neurostimulation adapters, in patients already implanted with SCS and experiencing lessening beneficial effects. .
One of the problems that the patients experienced was the loss of pain coverage as the device would no longer cover the areas causing pain.
- In the 11 of the 27 patients in this study with loss of pain coverage area, spinal cord stimulation adaptions results in efficacy on pain intensity of and were accompanied via paresthesia coverage recovery and pain surface decrease .
- At 12-month follow-up, 81.3% preferred to keep tonic stimulation in their waveform portfolio. Spinal cord stimulation syndrome conversion using adapters appears promising as a salvage solution, with an emphasis on paresthesia recapturing enabled via spatial retargeting.
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Disability Rights And The Americans With Disabilities Act
People with disabilities make up one of the largest minority groups in the country, as one and five Americans have one or more disabilities. In 1990, the Americans with Disabilities Act was put into place in order to protect the rights of people with disabilities. Specifically, for people with spinal cord injuries , the ADA provides the right to nondiscrimination and accessibility for public and private entities. Although the ADA protects the rights of people with disabilities, violations of the ADA take place every day across the country. The Spinal Cord Injury Law Firm has significant experience taking legal action for ADA violations. If you have sustained a spinal cord injury and have faced barriers to rights that are protected under the ADA, you may be able to take legal action.
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New Evidence That Spinal Cord Stimulation Is Helpful In Older Patients
In this article, we discussed the failure of spinal cord stimulators. We would like to again state that spinal cord stimulators do offer people relief.
A July 2021 study from the Department of Neuroscience and Experimental Therapeutics, Albany Medical College in New York examined the effectiveness of spinal cord stimulation in older patients by comparing their outcomes to middle-aged patients. The researchers noted that spinal cord stimulation is an effective chronic pain treatment most commonly used in middle-aged patients and that difficult to treat older patients with pain after spinal surgery should have results just as good. The cutoff line as being defined as older compared to middle-age was 65 years old. The researchers found and were able to provide evidence that This study represents the largest study where age was correlated to specific pain, depression, and disability outcomes following SCS. We provide evidence that spinal cord stimulation outcomes are equivalent, or better, in older patients following spinal cord stimulation. Based on these findings, spinal cord stimulation is a viable option for the treatment of chronic pain in elderly patient populations.
A June 2021 paper from the Departments of Anesthesiology, Amsterdam University Medical Centers, and published in the journal Pain and Therapy . The purpose of this study was to compare low and high-frequency devices and to assess their outcomes in helping patients.
Explanation For The Choice Of Comparators
Programmes incorporating the biopsychosocial approach into rehabilitation programmes for low back pain, thereby addressing physical deconditioning, pain coping mechanisms and workplace and health system barriers, revealed a positive effect on either RTW or reduction of the number of sick-leave days . In general, strength and endurance training , behavioural interventions and specific vocational training are key components of these programmes. Due to the limited number of patients with PSPS-T2 that is able to RTW after SCS implantation in Belgium, a personalised biopsychosocial rehabilitation programme of 14 weeks to improve RTW was developed. This new treatment will be compared to the usual care that is currently provided to patients after SCS implantation.
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What Are The Potential Complications Of A Spinal Cord Stimulator
Spinal cord stimulation is considered a safe procedure.
However, there are risks associated with any surgical procedure, including:
-Infection at implant site
– Device migration
– Damage to the device, typically caused by an injury, intense physical activity like heavy lifting, or physical trauma near the implant site
– Dural damage, leading to severe headaches
– Nerve damage and paralysis
Its important to note that serious biological complications, like dural damage, nerve damage or spinal trauma, are extremely rare6.
What Happens After Surgery
You will wake up in the recovery area. Your blood pressure, heart rate, and respiration will be monitored, and your pain will be addressed. Most patients are discharged home the same day or the following morning. The pulse generator will be programmed before you leave. You will be given written instructions to follow when you go home.
Follow the surgeonââ¬â¢s home care instructions for 2 weeks after surgery or until your follow-up appointment. In general, you can expect:
Restrictions
Do not bend, lift, twist your back or reach overhead for the next 6 weeks. This is to prevent the leads from moving out of place until it heals.
- Don’t lift anything heavier than 5 pounds.
- No strenuous activity including yard work, housework and sex.
- Don’t drive until your follow-up appointment.
- Don’t drink alcohol. It thins the blood and increases the risk of bleeding. Also, donât mix alcohol with pain medicines.
Incision Care
Medications
- Take pain medication as directed by your surgeon. Reduce the amount and frequency as your pain subsides. If you donât need the pain medicine, donât take it.
- Narcotics can cause constipation. Drink lots of water and eat high-fiber foods. Stool softeners and laxatives can help move the bowels. Colace, Senokot, Dulcolax, and Miralax are over-the-counter options.
Activity
When to Call Your Doctor
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Combined Use Of Dorsal Column Stimulation And Dorsal Root Ganglion Stimulation
Goebel and co-workers noted that limb amputation is sometimes being performed in long-standing CRPS, although little evidence is available guiding management decisions, including how CRPS recurrence should be managed. This report detailed the management of a young soldier with CRPS recurrence 2 years after mid-tibial amputation for CRPS. Conventional SCS did not achieve paresthetic coverage, or pain relief in the stump, whereas L4 DRG stimulation achieved both coverage and initially modest pain relief, and over time, substantial pain relief. The authors concluded that current evidence does not support the use of amputation to improve either pain or function in CRPS. Before a decision is made, in exceptional cases, about referral for amputation, DRG stimulation should be considered as a potentially effective treatment, even where conventional SCS has failed to achieve reliable paresthetic cover. Furthermore, this treatment may provide pain relief in those patients with CRPS recurrence in the stump after amputation.
There is currently insufficient evidence to support the combined use of dorsal column stimulation and dorsal root ganglion stimulation for the treatment of CRPS or any other indications.
Are Spinal Cord Stimulators Mri Compatible
No, MRIs are not always safe for those with spinal cord stimulation devices. Some newer devices are compatible with certain MRI machine models and scan locations, but your doctor will need to evaluate the specifics of your stimulator first. If your device is not MRI compatible, MRIs can cause serious injury.
Communicate with your pain specialist beforehand so that he or she can weigh in on whether a procedure will interfere with or harm your stimulator model.
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