Agree with lobel. Comments like “I’m a huge fan of Burst” can be what influences another young/less experienced/uneducated neuromodulator to start using a technology that is bad for the space. A documented lack of efficacy of greater than 50% along with non-rechargeable batteries that will need to be replaced every 2-3 years at $20,000 a piece will do nothing but bad things for SCS. When patients were carefully selected and implanted with Burst and then followed for a year (ie: the SUNBURST study) it was shown not to work very well at all. Props to them for actually publishing it and double props for marketing the crap out of it and getting so many guys to use it. Maybe everyone is buying in to the message “we didn’t know how to program it but we do now”. If there is any truth to this then it should be published but it’s not. There was a post market study of the patients enrolled in the SUNBURST study where they were reprogrammed to optimize the therapy but the results were never publicized. I know two of the study investigators and each had trouble getting the data from St. Jude for their own patients who were optimized. One was very aggressive about getting his data and was successful, said that there was only a 0.1 VAS improvement after optimization. I encourage us all to be doctors and make good decisions and leave the reps and marketing nonsense out of it.
Remember, all SCS works. If you do a trial on a good SCS candidate, whether it be with Nevro, Abbott, or the Medtronic system from 2005, there’s an 85% chance they come in 5 days later saying you’ve changed their life. What happens 3 months post implant when we’re brushing them off to the rep fro programming is where we fail. None of us follow our patients like is done in a level 1 study. Please, let’s all acknowledge that fact and use the evidence in front of us to make good choices about what’s been proven to work long term and make our specialty a light of promise in the opioid epidemic.
