Activity restriction after SCS implant

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
lmsanscafe

lmsanscafe

Full Member
7+ Year Member
Joined
Nov 6, 2015
Messages
27
Reaction score
17
Is there a good resource or guideline regarding this? What is your recommendation for your patients if they feel well enough to lift weights, run, swim, etc? Does it matter how long they’re removed from the implantation? Last follow up is does it differ if it’s a pump?

Inputs appreciated and thx in advance.
Members don't see this ad.
 
No blt for 6 wks.
Abd binder when oob
Biggest risk of not is lead migration which sucks.
 
Members don't see this ad :)
lmsanscafe said:
Thanks. Any restrictions after 6 weeks?
Click to expand...

Perc implants come at a certain cost with regard to post-implant activities, paddles much less so.

The types of activities that should be avoided are obvious.

I have pts who refuse to behave and do whatever they want and somehow the leads are still there several yrs later, and I have leads that have fractured and migrated outside the epidural space in pts who are very sedentary.

A pt who is going to require a lot of activity (manual labor for example) gets a paddle in my practice, especially young pts.

I promise you, the first time you revise a migration you'll question why you even offer this procedure to anyone. Seems like any revision I've ever done (whether I'm the original implanter or not), the reps always say both leads must be replaced. Interesting...
 
painfree23 said:
Wat about playing golf a year after paddles?
Click to expand...
No issues with a paddle, just remind them (if we're talking FBSS) they've got a back issue culminating in a freaking stimulator and probably need a new hobby.

If you put percs in a golfer you'll probably end up revising them at some point.
 
How many people do abdominal binders? What’s the benefit? Prevent seroma? More protection for wound?
 
Members don't see this ad :)
with the modern anchoring systems, and careful attention to suturing, the leads rarely move after 6 weeks in the absence of significant trauma or repetitive vigorous overhead motions like lat pulldowns.

I also use fixate devices which, while expensive, are well worth it IMO. Golf is rotary (if you're doing it right) and SCS implants will be fine.
 
I've implanted golfers too. Prefer not to...
 
What do you guys use to secure your SCS trial leads? My last trial patient scratched under his occlusive dressing "because it was itchy" and one lead was hanging out by the time he came in for the pull
 
Darkside_ said:
What do you guys use to secure your SCS trial leads? My last trial patient scratched under his occlusive dressing "because it was itchy" and one lead was hanging out by the time he came in for the pull
Click to expand...
Stayfix. A little costly but quick and very secure.
 
Darkside_ said:
What do you guys use to secure your SCS trial leads? My last trial patient scratched under his occlusive dressing "because it was itchy" and one lead was hanging out by the time he came in for the pull
Click to expand...
2-0 Vicryl x2 on each lead. A dab of dermabond over stab incision site to prevent bleeding. Benzoin and steri-strips as leads exit Vicryl.
Dressings over this done by my nurses and SCS reps.
 
Darkside_ said:
What do you guys use to secure your SCS trial leads? My last trial patient scratched under his occlusive dressing "because it was itchy" and one lead was hanging out by the time he came in for the pull
Click to expand...
I also suture the leads. I’ll throw some knots then create a strain relief loop and throw more using the same suture. Then mastisol, steris, and dressing.
 
I think there was an SCS fact finder on this recently noting increased migration with stitching. I use mastisol steristrips, tegaderm. I've had minimal migration.
 
If the leads move, it's almost always under the surface, from patient motion, and there's nothing other than education you can do about that, other than place leads 1/2 - 1 level higher than target in anticipation.
 
I suture to the leads themselves.

Trials migrate.
 
Truth be told.
Trials do migrate.
We have a bend test procedure immediately post-trial after leads sutured. Set the leads.
Patient gets up, bends to 90 degrees at waist with partial squat. Then back on table. This allows for more accurate programming.
 
You must log in or register to reply here.

Similar threads

Status Sciaticus
SCS Trial vs Implant pain relief?
Replies
18
Views
2K
Ducttape
D
D
1.25m SCS Implant Settlement
Replies
35
Views
3K
drmamba
D
H
No Skin Prep before SCS Implant
Replies
23
Views
1K
CleanUp
CleanUp
R
  • Poll Poll
SCS Implant Volumes in Academic Centres
Replies
1
Views
640
Orin
O
P
Leg pain after SCS trial
Replies
20
Views
2K
po_boy
P
Top