ANS vs Medtronics SCS

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I'm really interested in hearing what everyone thinks. Which system do you prefer and why?

At this point for me it boils down to who has the best support team (physican, patient, office support). The way the ANS or Medtronics rep interacts with your patients reflects on you and in my novice opinion that means a lot!

Originally Posted by PainDr

I'm really interested in hearing what everyone thinks. Which system do you prefer and why?

Gigadittos on that. By far that is the most important factor. A bad rep can sink your program and cause you immense headaches. Find one system and stick with it. It is much more difficult to have a practice with all three manufacturers having implants in your patients and even two manufacturers are usually not necessary unless there are special circumstances.

That was kind of what I thought as well, but the problem is, both of my reps are fantastic. I wish one was better because that would make the decision easier, but both of them are really good.

What about the support for reimbursement issues? Anyone have better interactions with one company or the other?

Thanks!

I am a do it yourself kind of guy (aka "obsessive-compulsive / can't delegate tasks"), so I like MDT because I can program the stims myself using the combo pump/stim programmer. In Houston the other pain docs seem to leave it to the reps to do all of the programming. I'd do that if I had never seen a "failed" stim that I managed to salvage with reprogramming.

I recall one instance where a patient came to see me for a failed stim done by one of my colleagues. It worked fine prior to IPG replacement and then they couldn't seem to get it working again. The stim worked beautifully once I raised the rate from 30 to 70. The implanter never looked at it, only the rep.

You have to understand the diseases the equipment gets as well as the diseases the patient gets.

Seems like it comes down to MDT vs. ANS for all you guys. Is there something I should know about the Advanced Bionics SCS? They have a fantastic rep in this area, and I like using the Precision system.

they should be fantastic......they make upwards of 150K a year. A rep got drunk and spilled the beans once....said he was shooting for 250K a year.

T

Advanced Bionics, in my area at least, has a very poor reputation due to poor representation and management. I've talked to other pain docs about AB and frequently hear about similar problems. To be honest, the AB product looks worth a try otherwise. Anybody else have similar issues with AB?

Originally Posted by Doctodd

they should be fantastic......they make upwards of 150K a year. A rep got drunk and spilled the beans once....said he was shooting for 250K a year.

T

We are on the verge of starting to use Advanced Bionics. The reps in our area are pretty aggressive but Medtronic and particularly ANS are really entrenched here. (Jefferson did some of the groundbreaking work with ANS) It will be interesting to see how the AB folks respond to this trial period. Although I agree with Algos' and Ligament's comments wholeheartedly, I think some of what is used depends on history (i.e. who you trained with, who you are comfortable with).

In my opinion, customer service is king (specifically patient follow-up and office support). Technology is just the icing on the cake... but here are some distinctions that I've noticed with the technologies.

ANS - Represent the overwhelming majority of implants in my area. Constant Current system is the #1 feature. Patients who've tried both Medtronic's constant voltage and ANS' constant current feel a deeper and and more complete stimulation with the Constant Current system. #2 feature is frequency. ANS can go up to 1200 Hz. Medtronic can go up to 130 Hz. Read the literature and you'll notice that frequencies >250 Hz have been shown to recapture lost paraesthesia in CRPS patients and are often preferred right out of the gate in a trial. Big difference when you have a system that can't even reach a high frequency. #3 feature is simplicity. All of the ANS leads are compatible with both the conventional and rechargeable generator. A lot of Medtronic leads require an extension, adding an extra point of system failure.

Medtronic - Very few practices in my area still use Medtronic, and only do so because they've had a long relationship with the rep, which is understandable in my opinion. The only advantage to their system is they offer the intrathecal pumps. Whether's there's really a need for intrathecal pumps in the first place is highly debatable in my opinion.

ABi - Never made much of an impact in my area because the reps were rather inexperienced. Personally, I love the smaller generator (even with the shorter battery life), but their leads are inferior. ABi leads only cover 1 vertebral segment. ANS and Medtronic cover 2 segments. When you consider lead migration and neuroplasticity, that's too much of a liability in my opinion. Otherwise, they do offer some of the same advantages of ANS (constant current, high frequency).