Neuromodulation Poll

[101N]

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Bsx

stj

mdt

 

[pjuer]

mdt

 

[Aether2000]

All 3

 

[OffPiste]

St Jude rep is best in my area, has helped me a ton, so mostly use these guys, plus Penta lead is best paddle IMHO.
Frankly, I think I can make a trial work with all three, so I do spread the love a bit

 

[Ducttape]

Has anyone noticed an appreciable difference in quality for non-extremity pain syndromes?

Gonna start doing a few trials for chronic pancreatitis and angina.. Currently use primarily mdt and stj for radiculopathy pain syndromes...

 

[bedrock]

Has anyone noticed an appreciable difference in quality for non-extremity pain syndromes?

Gonna start doing a few trials for chronic pancreatitis and angina.. Currently use primarily mdt and stj for radiculopathy pain syndromes...

How hard is it to get paid for those diagnoses? I've seen the literature supporting it, but it seem like no insurance co reimburses stim for those diagnoses.

 

[bedrock]

mdt
sjt

 

[CB1Antagonist]

Sjm

mdt

 

[clubdeac]

St jude majority

Boston sometimes

 

[Ligament]

I use all three, but prefer St. Jude.

 

[101N]

I use all three, but prefer St. Jude.

Reps in my area: 1. STJ, 2. BSX, 99. MDT

Since I trial and refer for paddles: STJ as the Penta is 'theoretically' superior

 

[jettavr6]

1 bsx
2 mdt
3. Sj

 

[facets]

I love the st J reps, they are always right there for patient calls and mine, plus the penta is the bomb

 

[giddyup]

we use bs exclusively. mdt reps pushy in our area. my attending who does them feels like the bs lead programmability is superior. we have actually taken out some mdt and replaced them with bs and have gotten much better coverage.

 

[Mister Mxyzptlk]

Been with MDT since I was a tadpole and have long and great relationship with them. I like the new adaptive stim and it looks like they are going to have MRI-approved systems out.

 

[epidural man]

Bsx

stj

mdt

any thought to the constant voltage vs constant current arguement?

I asked the medtronix rep if they would support me doing a clinical trial with OMG device - blinded to patient and rep - to see if a) they could tell a difference, and b) if the difference felt better/worse.

You would think - that if the medtronix guys were SOOO SURE that it didn't make a difference, they would throw MONEY at me to do this study. Yet they balk. They give me engineering talk, they give me their speech - but where is the support to PROVE IT? I don't care what the engineers claim. Let's do the study! Let's get the data!

I do have concerns about constant voltage over the long haul. I do think that constant current has a better ability to adapt to resistance changes. Also, I think a huge issue with MOST of the studies that look at long term data is that they have been done with constant voltage systems.

And frankly, with the constant current systems, I never even knew positional changes were a big issue - but apparently it is a huge issue with constant voltage systems.

Having said that and revealing my biasis, I have used medtronic with some success. I still think they lack in their ability to program and to steer current. The fact that BS has 16 independant sources is pretty cool. The fact that St Jude can switch from multiple programs in fractions of a sec is pretty cool as well. I think that makes a difference in some clinical scenarios. I'm also very excited to place perc paddle leads. We will see if that is game changer.

 

[101N]

any thought to the constant voltage vs constant current arguement?

I asked the medtronix rep if they would support me doing a clinical trial with OMG device - blinded to patient and rep - to see if a) they could tell a difference, and b) if the difference felt better/worse.

You would think - that if the medtronix guys were SOOO SURE that it didn't make a difference, they would throw MONEY at me to do this study. Yet they balk. They give me engineering talk, they give me their speech - but where is the support to PROVE IT? I don't care what the engineers claim. Let's do the study! Let's get the data!

I do have concerns about constant voltage over the long haul. I do think that constant current has a better ability to adapt to resistance changes. Also, I think a huge issue with MOST of the studies that look at long term data is that they have been done with constant voltage systems.

And frankly, with the constant current systems, I never even knew positional changes were a big issue - but apparently it is a huge issue with constant voltage systems.

Having said that and revealing my biasis, I have used medtronic with some success. I still think they lack in their ability to program and to steer current. The fact that BS has 16 independant sources is pretty cool. The fact that St Jude can switch from multiple programs in fractions of a sec is pretty cool as well. I think that makes a difference in some clinical scenarios. I'm also very excited to place perc paddle leads. We will see if that is game changer.

Good points. I don't have an answer. This year at NANS there was an Italian group that compared the outcomes of the three systems and found no clinically significant difference.

In my area St. Jude rules the roost. The reps, and company business plan, are just superior. That has influenced me as much - if not more - than the technology. But I am a simple dude, in hind sight I probably should have been an orthopedist. Bigger is better, I like the Penta🙂