Curonix was Stimwave

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lobelsteve

lobelsteve

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Magic beans?

www.justice.gov

Former CEO Of Medical Device Company Indicted For Creating And Selling A Fake Medical Component That Was Implanted Into Patients

www.justice.gov www.justice.gov

IMG_3575.png



I don’t buy it. PNS never worked before.
 
lobelsteve said:
Magic beans?

www.justice.gov

Former CEO Of Medical Device Company Indicted For Creating And Selling A Fake Medical Component That Was Implanted Into Patients

www.justice.gov www.justice.gov

I don’t buy it. PNS never worked before.
Click to expand...
Lots of magic beans in pain medicine, why do you not like this one specifically?

PNS (Temporary abolition of pain in man - PubMed) worked before SCS (Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report - PubMed) did, but it didn't commercialize well due to the hardware issues. Even them though, off label SCS hardware used to work great until it moved, broke, eroded in my experience.

With that said, I'd rather RFA a knee than stim it.
 
lobelsteve said:
Magic beans?

www.justice.gov

Former CEO Of Medical Device Company Indicted For Creating And Selling A Fake Medical Component That Was Implanted Into Patients

www.justice.gov www.justice.gov

View attachment 375843


I don’t buy it. PNS never worked before.
Click to expand...

Magic electrons.

Next up:

www.prnewswire.com

Nevro Reports Second Quarter 2023 Financial Results, Provides Third Quarter Guidance and Updates Full-Year 2023 Guidance

/PRNewswire/ -- Nevro Corp. (NYSE: NVRO), a global medical device company that is delivering comprehensive, life-changing solutions for the treatment of...
www.prnewswire.com www.prnewswire.com

  • Second Quarter 2023 Net Loss from Operations of $25.6 Million; Second Quarter 2023 Non-GAAP Adjusted EBITDA Loss of $3.1 Million
 
drusso said:
Magic electrons.

Next up:

www.prnewswire.com

Nevro Reports Second Quarter 2023 Financial Results, Provides Third Quarter Guidance and Updates Full-Year 2023 Guidance

/PRNewswire/ -- Nevro Corp. (NYSE: NVRO), a global medical device company that is delivering comprehensive, life-changing solutions for the treatment of...
www.prnewswire.com www.prnewswire.com

  • Second Quarter 2023 Net Loss from Operations of $25.6 Million; Second Quarter 2023 Non-GAAP Adjusted EBITDA Loss of $3.1 Million
Click to expand...
Glad I am risk averse. Index funds for me.
 
Ronin1 said:
I’ve done four PNS geniculate stim implants with Nalu over the last 4 months. All 40-70% improved over baseline. All failed TKRs. All miserable before not so much now.
Click to expand...
Private practice or hospital?
 
Ronin1 said:
I’ve done four PNS geniculate stim implants with Nalu over the last 4 months. All 40-70% improved over baseline. All failed TKRs. All miserable before not so much now.
Click to expand...
Wait til 6 mo. Honeymoon is over.
 
Ronin1 said:
I’ve done four PNS geniculate stim implants with Nalu over the last 4 months. All 40-70% improved over baseline. All failed TKRs. All miserable before not so much now.
Click to expand...

Next time try squirting some phenol on the genicular nerves and tell me what happens.

pubmed.ncbi.nlm.nih.gov

Chemical Ablation of Genicular Nerve with Phenol for Pain Relief in Patients with Knee Osteoarthritis: A Prospective Study - PubMed

Chemical neurolysis of genicular nerves with phenol provided efficacious analgesia and functional improvement for at least 6 months in most patients with a low incidence of adverse effects.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

www.sciencedirect.com

Genicular nerve neurolysis with phenol for chronic knee pain: A case series

Chronic knee pain continues to be a common complaint amongst patients and continues to grow as the elderly population lives longer. New ways to treat …
www.sciencedirect.com www.sciencedirect.com
 
@lobelsteve have you explored academic pain medicine where non-interventionalists pontificate about central pain and claim no intervention works?

(Kidding)
 
Did tons of PNS in the L8680 days. Man did my boss make great money. Theatric placebo (cue drusso).
Crappy literature.

Anyone catch on to how new procedures are developed?

1. Company gets investment capitol.
2. Company creates a new procedure/device
3. Company hires KOL to tell us how wonderful it is.
4. Company funds KOL to do research controlled by company with poor study design.
5. Some folks start doing procedure and results are amazing.
6. No one talks about failures.
7. No one does independent research.
8. It doesn't work.

Pain is a bunch of ****** in pointy toed shoes trying to out do each other. Just check out LinkedIn, the bragging grounds where there are daily tryouts to become the next Timmy.
 
True. I don’t believe the hype from the talking heads etc, we will see how these pan out long term, for select patients it’s seems to be a reasonable option with the current technology. I don’t think you can equate previous attempts at PNS with the current systems.
 
lobelsteve said:
Did tons of PNS in the L8680 days. Man did my boss make great money. Theatric placebo (cue drusso).
Crappy literature.

Anyone catch on to how new procedures are developed?

1. Company gets investment capitol.
2. Company creates a new procedure/device
3. Company hires KOL to tell us how wonderful it is.
4. Company funds KOL to do research controlled by company with poor study design.
5. Some folks start doing procedure and results are amazing.
6. No one talks about failures.
7. No one does independent research.
8. It doesn't work.

Pain is a bunch of ****** in pointy toed shoes trying to out do each other. Just check out LinkedIn, the bragging grounds where there are daily tryouts to become the next Timmy.
Click to expand...

Do you think nevro scs works?
 
 
Espn123 said:
Do you think nevro scs works?
Click to expand...
I use Nevro not infrequently, but IMO (not that you asked me) it is inferior to Abbott.

Especially now that Abbott launched Eterna, I am not sure how much longer I'll offer Nevro (or BSc). It seems I have more frustrated Nevro pts than Abbott.
 
MitchLevi said:
I use Nevro not infrequently, but IMO (not that you asked me) it is inferior to Abbott.

Especially now that Abbott launched Eterna, I am not sure how much longer I'll offer Nevro (or BSc). It seems I have more frustrated Nevro pts than Abbott.
Click to expand...
The other way around.
 
 
MitchLevi said:
I use Nevro not infrequently, but IMO (not that you asked me) it is inferior to Abbott.

Especially now that Abbott launched Eterna, I am not sure how much longer I'll offer Nevro (or BSc). It seems I have more frustrated Nevro pts than Abbott.
Click to expand...
I was poking a little fun @lobelsteve bc in my opinion this “new procedure” follows his steps very elegantly
 
lobelsteve said:
I do not even know what is going on.
Click to expand...
I guess my unsuccessful attempt to suggest nevro scs follows the same path that you described quite well.

I’d also add that I don’t think we will see new treatment options or technology follow any other pathway than this in today’s day and age. The desire for new options (whatever the motive may be) and the need for it will always outpace the speed at which proper non-sponsored research can keep up with.
 
Last edited:
Seeing Curonix more visible now on social media and I know some physicians using it. I'd love to know how they managed to pivot. Is the technology different now? Anyone have experience?


Also, the story of the fraud is sad and fascinating. Did this one CEO somehow act alone to make a plastic stylet? Did no one else know? Were all the reps and other execs and engineers completely in the dark? Someone needs to do a long form deep dive on this story.
 
I've only done one Genicular PNS (Nalu) and that was for a patient who developed severe neuropathic pain in her knee after TKA. The patient reported considerable pain relief after implant. I haven't heard from them in over 6 months. But there was no good location to place the disc and in my opinion, it is an impractical system due to inadequate good placing for the disc (which is also quite bulky. In the end, I kinda wished I just did DRG/SCS.
 
lobelsteve said:
Magic beans?

www.justice.gov

Former CEO Of Medical Device Company Indicted For Creating And Selling A Fake Medical Component That Was Implanted Into Patients

www.justice.gov www.justice.gov

View attachment 375843


I don’t buy it. PNS never worked before.
Click to expand...
www.justice.gov

Former CEO Of Medical Device Company Convicted Of Creating And Selling A Fake Component That Was Implanted Into Patients

Damian Williams, the United States Attorney for the Southern District of New York, announced that a jury returned a guilty verdict today against LAURA PERRYMAN on two counts of an Indictment charging her with conspiracy to commit health care fraud and wire fraud and substantive health care fraud...
www.justice.gov www.justice.gov
 
drg123 said:
Seeing Curonix more visible now on social media and I know some physicians using it. I'd love to know how they managed to pivot. Is the technology different now? Anyone have experience?


Also, the story of the fraud is sad and fascinating. Did this one CEO somehow act alone to make a plastic stylet? Did no one else know? Were all the reps and other execs and engineers completely in the dark? Someone needs to do a long form deep dive on this story.
Click to expand...
Tech is still the same
They're cutting pricing relative to competitor products so more usage

Supposedly some folks did push back but not sure those people are still with the company
It would be a good documentary

I'm not sure how they're still using their codes with the new PNS code. They say it doesn't apply to them, but it seems to be precisely written for them. Bioventus uses it as it is more $$ than a 64555 but it's less than 64555+64590 for a PNS and generator which Stimwave/Curonix uses.

64596INSERTION OR REPLACEMENT OF PERCUTANEOUS ELECTRODE ARRAY, PERIPHERAL NERVE, WITH INTEGRATED NEUROSTIMULATOR, INCLUDING IMAGING GUIDANCE, WHEN PERFORMED; INITIAL ELECTRODE ARRAY
 
I’ve found insurance coverage to be so poor that I’m surprised the peripheral nerve stimulators are still in business

They are spending a ton of dollars advertising it to doctors. At the Texas pain society meeting every case presentation was a Sprint PNS implant
 
I think the issue is the device works with a pink stylette, a white stylette, or no stylette. I don’t think she intentionally disabled her device and the patient never felt anything after implant.
 
lobelsteve said:
www.justice.gov

Former CEO Of Medical Device Company Sentenced To Six Years In Prison For Creating And Selling A Fake Component That Was Implanted Into Patients

Damian Williams, the United States Attorney for the Southern District of New York, announced that LAURA PERRYMAN was sentenced today to six years in prison in connection with a health care fraud scheme whereby PERRYMAN created and sold a fake medical device component and told doctors that they...
www.justice.gov www.justice.gov
Click to expand...

Is she tender to palpation over the area near the region of the cluneal nerves?
 
drusso said:
Next time try squirting some phenol on the genicular nerves and tell me what happens.

pubmed.ncbi.nlm.nih.gov

Chemical Ablation of Genicular Nerve with Phenol for Pain Relief in Patients with Knee Osteoarthritis: A Prospective Study - PubMed

Chemical neurolysis of genicular nerves with phenol provided efficacious analgesia and functional improvement for at least 6 months in most patients with a low incidence of adverse effects.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

www.sciencedirect.com

Genicular nerve neurolysis with phenol for chronic knee pain: A case series

Chronic knee pain continues to be a common complaint amongst patients and continues to grow as the elderly population lives longer. New ways to treat …
www.sciencedirect.com www.sciencedirect.com
Click to expand...

I’ve read about this. Seems safe and logical. Why are more not trying?
 
my understanding is that phenol can cause permanent damage, as opposed to RFA.

which is why we dont use phenol for facet arthropathy.

phenol is not that hard to get.


every 2 years, this post about phenol for ablation comes up. eventually, those who ask come to their senses and give up on the idea.
 
Ducttape said:
my understanding is that phenol can cause permanent damage, as opposed to RFA.

which is why we dont use phenol for facet arthropathy.

phenol is not that hard to get.


every 2 years, this post about phenol for ablation comes up. eventually, those who ask come to their senses and give up on the idea.
Click to expand...
Do we care about permanent damage of genicular nerves? Seems this would be beneficial and lead to reduced need for future ablations and more compete destruction

Isn’t there worry of neuromas with phenol?
 
Ducttape said:
um... neuromas are the permanent damage...





its about this time in the newbies time on the forum that someone mentions IDET and epidurolysis...
Click to expand...
Target cath baby, one of my favorite procedures to do. I did enjoy discograms back in the day too. Turn the dial, make him holler.
 
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