Debating SCS- Senza Nevro HF10 system or the Boston Scientific system

So, I had my whole entire story typed out and my browser crashed. So here goes… I just got the permanent spinal cord stimulator by Boston Scientific 4 weeks back.  So a little back-ground as to why I went this route.  3 years ago, I was in a really horrible ATV accident and about lost my lower leg.  I had 3 surgeries in 14 months and was in so much daily pain.  The pain meds were only making it were I could semi function throughout the day.  But my life was a living hell.  I used to ride aggressively, wakeboard, bike, tube, hike, snowmobile, etc.  Now all I did was work and come home and lay in bed.  I couldn’t ever sleep at night.  I was so depressed with my life and during all this I lost my house; my powerboat, my really good job, and the bills were out-of-control. 

Finally my pain specialist mentioned the SCS, and to look into it.  I went ahead 6 months later, after playing all the games that the insurance company wants you to do beforehand getting the trial 3 days after getting it, they had to pull it as the lead had moved, and was pushing against a nerve. Thinking I wouldn’t be able to get the permanent because the trial was a failure. Well 4 weeks back I received the permanent one.  I was referred to a different doctor because of my active lifestyle. She ended up doing a laminectomy with the bigger leads (glad I went this route).  I’m simply still in shock with how it’s changed my life! I think because the type of nerve damage, it has worked well for me!  I still have to take some pain meds, but when I do, I’m at 100%.  The wonderful thing about the Boston Scientific, is I have it programmed at the high frequency, so I don’t feel anything like NEVRO, but I also have other programs, so depending on my pain, these different choices are amazing.  Sometimes I need to have the jolting like feeling; which for me is like heaven!  The nice thing with the Boston Scientific is you can do the program that is silent, or one that is more pulse-like, or an electric stimulation – which offers a consistent flow.  My programmer with the company is amazing, and can essentially make it do anything you would like to assist with “YOUR” pain.

The battery doesn’t need charged but every couple of weeks; which for me is a plus.  Yes I can’t have MRI’s, but from my research, you can achieve CAT Scans and such that will generally show needed problems which MRI’s show, simply based on today’s technology.

I have the implant placed a little higher, as I was asked questions like where do I wear my jeans and such.  Because I wear jeans lower, she placed it a little higher.  I can still sleep on my right side; even though it’s placed on my right.  I can’t begin to tell you how it has changed my life.  If anyone has questions about things please feel free to contact me!

Kilee, I have had 3 back surgeries, 1 failed lamenectomy and 2 fusions and I am in constant pain. Actually I started feeling better a year ago but then in December I found out I had breast cancer, I had a lumpectomy and 63 radiation treatments. When the Techs were positioning me my back was moved and rotated each time. Now I am in a great deal of pain and in bed a lot.

A couple years ago I had the trial of the pain pump and the trial of the pain stimulator (Medtronic) and neither worked for me. My pain Dr wants me to do the trial of the Nevro HF10 pain stimulator, but I'm not sure if my body can tolerate another surgery. I will be having another breast cancer surgery in either October or November, they have to wait 6 months after I finished my radiation. If I have the trial it would probably be in January 2017 because I want to be healed from the breast surgery. If I go ahead with the trial of the Nevro HF10 it will be my 9th surgery in 6 years.

What did you decide about the Nevro HF10, did it work, did you try something else or are you still trying to decide? Thank you ahead of time for your answer. I would also like others to comment their results of the Nevro HF10.

This is an old discussion, but several points worthy of comment, came up as people struggled to make decisions. glxpassat made the best comparison, from my experience. After implanting for 30 years (the first ones were really primitive), I have come to currently most often recommend the Boston Scientific for the reasons glxpassat expressed.  These are medical opinions of an experienced physician. Your opinion may vary.

Boston, and now Nuvectra) have individually powered contacts, so the current really is constant when the programming is set. With a common generator for all, as in Medtronic and some others)regional impedance changes cause fluctuation in all contacts.

There is the option for 32 contacts. (for example, for the rare person who needs both upper and lower extremity stim, though it is true that an upper spinal cord stim can often be programmed to reach deep enough to also affect lower extremities. So 1 generator can power both leg and arm pain, for example.

The option for both high frequency (not perceived) and the classic, lower frequency rate that is felt by the patient, has merit in many patients as expressed by glxpassat. Medtronic also has this, but not the advanced independent power sources.

Full body MRI compatibility is available for the Boston unit at present, as is for Medtronics and Nevro.

Boston charging system seems pretty good, perhaps the best, overall. And more resilient battery.

Nevro, so far, has been 0 for 3 in my experience. There is no way to place it precisely, as there is no perception. So the benefits of accurate placement (as utilized by all other systems) are apparently simply ignored. If it works for you, great. But there appears a larger element of luck. (Also, the doctor doesn't need as much time or expertise for placement, so maybe this appeals to those docs who can't or won't develop the expertise)

Medtronics is high quality, but dated. Boston's batteries are more tolerant of individual screw-up, and everyone screws up. These are highly technical systems and not all patients have the background or energy to grasp them, nor should patients be expected to become electronics experts. 

The high frequency only systems (Nevro, StimWave, etc) hold promise, but appear to have generally lower success than advertised and often seem to over simplify placement accuracy. 

A few more general bits that evolved over the years:  Simple, percutaneous (round) leads are generally preferred over paddles, though far too many paddles continue to be used, for reasons of economics for the hospital and doctor, as well as for incomplete awareness by various physicians. The perc leads only require needle insertion and can be easily adjusted in future, in case lead migration occurs, with simple access to the entry site, whereas the paddles require surgical placement and cannot be adjusted without another surgical procedure, or, in the event of extensive epidural scarring, they may require more extensive surgery to correct. They should be reserved for clearly indicated cases.

As for other common concerns expressed on this group: Never, never feel pressured by reps or doctors. If you sense pressure, get a second opinion, or a third. While there are many excellent, thoughtful and skilled pain docs, there are far too many "wannabes" who have only partial skills, or only want to do part of the placement/management, or do a bit of "throwing some leads in) while their main practice is other things, such as craniotomies or bone repair. (Eg: the anesthesiologist who only wants to trial and the neurosurgeon or orthopod who only wants to place paddles (paddles generate $4x the fee for perc leads). There are still too many docs who see a stim or pump as a "final solution", whereas I prefer to see it as initiating a new line of treatment, which must be managed for however long it takes. This approach has allowed a number of patients to gradually resolve their pain to, if not zero, tolerable to a point that they require tiny fractions of their original meds. It often takes years. So be it. There is the occasional patient who benefits from both stim and pump. There are pts who finally obtain good relief after miserable pain, with stim, pump or both, and after a number of years of neuromodulation, (stim, pump or both) they may be able to gradually reduce all pain treatment modalities to very low levels, occasionally zero. Everyone varies. Each must be individualized.

Continue careful review of options. When you select one, do your best to see that it remains flexible and can incorporate other options if necessary. There is rarely a magic bullet. When you experience that, lucky you.

Cheers.

I have the HF10. I had back pain for over 25 years, tried everything had one surgery. I am very pleased with my results .

i had a Medtronic NS implanted in Dec 2018. it worked well for sciatica for 5 years, then i started having issues as my back and sciatic pain got worse. my implant was mainly for scuaric pain not back pain. i also have foot pain due to 2 foot surgeries. now its not working that well anymore. i have to turn it up so high that the parasthesia is too much.

Now they want to revise the implant to either Nevro or BS. BUT i dont know which one to choose?

They did some sort of upgrade on the Medtronic implant trying to get the parasthesia down as much as possible, but its still not working.

I also have numbness/pain in my hands and and hardware in my neck from the original injury that started all this.

i need something that will address all areas of pain. im ok with a light degree of parasthesia, just not a lot.

i had mine programed at first with the proximal auto-adjustment program and i could not STAND the jumping around as i moved-total waste of time countering those sudden jumps if you even turn on your side or recline.

The Boston stim say it can do both parasthesia or not, or both at once in different areas.

any input would be helpful. my surgery is sceduled for Nov 14th, 2018

I have the SENZA FIE 2 yrs and it's worked great.