Sprint PNS

[HouseofPain]

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Is anyone here doing this? If so what kind of results have you been getting? This would be great for my practice if it works but I’m always somewhat cynical of “new and upcoming pain systems/procedures”. It does seem better than stimwave from what I’ve been reading.

 

[No Pain All gain]

Totally different. Temporary PNS monopolar stimulation for 30-60 days. Published work shows carryover relief after lead pull to 12 months in amputees and axial low back in about 2/3 patients. Lead pulls out early about 1/4 of the time

My practice has been to use this and if PNS works but carryover relief not durable then implant with previously Bioness or Stimwave. Now curious about Nalu.


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[HouseofPain]

Totally different. Temporary PNS monopolar stimulation for 30-60 days. Published work shows carryover relief after lead pull to 12 months in amputees and axial low back in about 2/3 patients. Lead pulls out early about 1/4 of the time

My practice has been to use this and if PNS works but carryover relief not durable then implant with previously Bioness or Stimwave. Now curious about Nalu.


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Awesome. I know it’s just a 60 day max use but do you feel you’ve been getting prolonged relief after removal for most of your patients? I would go this route prior to implanting stimwave also

 

[Green Grass]

Totally different. Temporary PNS monopolar stimulation for 30-60 days. Published work shows carryover relief after lead pull to 12 months in amputees and axial low back in about 2/3 patients. Lead pulls out early about 1/4 of the time

My practice has been to use this and if PNS works but carryover relief not durable then implant with previously Bioness or Stimwave. Now curious about Nalu.


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All of the above. Also worth mentioning to the patient that a decent percentage of these leads break with pull so they may end up a small metal fragment left behind. I've had a few get great results, but many don't get the long term relief we are hoping for.

 

[Ligament]

ttt

 

[drusso]

All of the above. Also worth mentioning to the patient that a decent percentage of these leads break with pull so they may end up a small metal fragment left behind. I've had a few get great results, but many don't get the long term relief we are hoping for.

Does anyone know why it requires an ASC for the implant?

 

[ateria radicularis magna]

All of the above. Also worth mentioning to the patient that a decent percentage of these leads break with pull so they may end up a small metal fragment left behind. I've had a few get great results, but many don't get the long term relief we are hoping for.

Would this small fragment preclude mri?

 

[stsa84]

Nope, it doesn't

 

[BloodySurgeon]

I havent used the sprint PNS before, how much different is it compared to other PNS? Please share your experience and approach.

Also are you guys using this for post-amputation pain? How long do you wait after surgery before implant? Where do you place them (femoral vs. sciatic)?

 

[epidural man]

I havent used the sprint PNS before, how much different is it compared to other PNS? Please share your experience and approach.

Also are you guys using this for post-amputation pain? How long do you wait after surgery before implant? Where do you place them (femoral vs. sciatic)?

A lot easier to place than regular PNS.

 

[Ligament]

IMPORTANT: SPRINT is only reimbursed in hospital and ASC settings, NOT in the clinic.

Which is INSANE, as nothing about it requires any hospital nor ASC services. You place it under ultrasound like any simple in-clinic procedure.

 

[drusso]

IMPORTANT: SPRINT is only reimbursed in hospital and ASC settings, NOT in the clinic.

Which is INSANE, as nothing about it requires any hospital nor ASC services. You place it under ultrasound like any simple in-clinic procedure.

Does anyone know why?

 

[ateria radicularis magna]

Bump

 

[GoBeers]

because of cost of the system

 

[Ligament]

because of cost of the system

That has no bearing on anything. Doing this procedure in a hospital or ASC adds even more cost to the system.

 

[DOctorJay]

It’s a good question. I have a meeting on Friday and will see if I can get some clarification.

 

[gdub25]

Please let us know and if you could get the codes and reimbursement it would be great.

 

[DOctorJay]

meeting got pushed to next Friday. I'll update when I can.

 

[SommeRiver]

I tried to start doing these two yrs ago and it was cost prohibitive. Couldn't make it worth doing in our ASC and I'm not going to the hospital for what it pays.

I'd love to hear an update.

 

[NJPAIN]

I’m seeing some early decent results but not certain of durability of results yet.

With reimbursement the way it is professional fees are all nickel and dime now. I’ve been told that you could do some WC or auto accident cases in office. However, equipment costs are high. All you need is a denial of payment and there go your profits on the next few cases.

I’m certain it will turn into the next 8 minute procedure, 10 of them before noon, to help the patient who has failed SCS, Vertiflex, Minuteman and bilateral SIJ fusion.

 

[Ligament]

My rep told me cash pay prices is $8200 for the equipment alone. So if you want to do this in a clinic, patient needs to ante up with that plus your professional fee.

 

[DOctorJay]

so the meeting I had was just with one of our administrators. I asked him to find out more about the codes used and rationale behind HOPD site only. as mentioned above it's probably the kit cost issue.

 

[au bon pain]

Two Sprint reps told me the same thing: kit is too expensive to make it feasible to do outside an ASC/hospital. One said that if there's a lead failure there's no cost for a replacement so that's the only time he's seen one done in the office.

 

[BobBarker]

$8200 is a lot of money. You could probably get a Boston Spectra with one lead for that much.

 

[Orin]

Y'all ever notice how trial leads prices vary sometimes per site of service? This thing probably costs way less to make, but they're pricing it to the payment for the CPT per that site of service to have a good margin.

I love the idea of it, but eventually I suspect CMS will look at this and ask why it isn't a peripheral field stimulator or a percutaneous electrical nerve stimulators. At that point, I'm not sure where their business model goes.

 

[drusso]

Y'all ever notice how trial leads prices vary sometimes per site of service? This thing probably costs way less to make, but they're pricing it to the payment for the CPT per that site of service to have a good margin.

I love the idea of it, but eventually I suspect CMS will look at this and ask why it isn't a peripheral field stimulator or a percutaneous electrical nerve stimulators. At that point, I'm not sure where their business model goes.

 

[Ligament]

Two Sprint reps told me the same thing: kit is too expensive to make it feasible to do outside an ASC/hospital. One said that if there's a lead failure there's no cost for a replacement so that's the only time he's seen one done in the office.

Guys...its "too expensive" because they are milking the SOS payments at hospitals and ASCs to get more profit. If those did not exist, you bet your ass they'd price it to work in a clinic.

 

[NJPAIN]

Two Sprint reps told me the same thing: kit is too expensive to make it feasible to do outside an ASC/hospital. One said that if there's a lead failure there's no cost for a replacement so that's the only time he's seen one done in the office.

I was told same thing. Had a lumbar SPRINT in which one lead acting up. Rep told me that they would give the lead for free and I could replace in office with US and charge for the lead. Really speaks volumes about the amount of profit on the lead.

 

[Ligament]

The lead is a coil of wire that probably costs $20 max to make. Its not hand spun or hand wound and intricate like SCS leads...its simply a wire.

 

[TIVAndy]

i think the lead cost is around 7800 with discount - asking price is higher. destroys almost all profit at ASC even.

 

[NJPAIN]

The blanket denials of PNS are starting to roll in. Just received an email to sign a petition encouraging BCBS not to implement blanket denial policy. This is what happens when you train dozens of docs every weekend and they use it like a hammer looking for a nail as part of the new algorithm: injections, RF, SCS, DRG, Vertiflex. Minuteman, bilateral SIJ fusion, PUMP, SPRINT ——> then you get a NEG UDS and kick the patient out of the practice—- REPEAT.

 

[BobBarker]

I have been interested in PNS but like I told a few of the reps, I have no idea how to identify these patients and haven’t seen one that comes to mind as a great candidate. Certainly, do not understand how someone could be doing multiple per week.

 

[drusso]

I have been interested in PNS but like I told a few of the reps, I have no idea how to identify these patients and haven’t seen one that comes to mind as a great candidate. Certainly, do not understand how someone could be doing multiple per week.

The cluneal nerves are good after failed SIJ fusions, but make sure they fail the fusion first. Counsel patients, "If this doesn't work, we'll do that; and if that doesn't work, we'll do this..."

 

[BobBarker]

The cluneal nerves are good after failed SIJ fusions, but make sure they fail the fusion first. Counsel patients, "If this doesn't work, we'll do that; and if that doesn't work, we'll do this..."

You could also fuse it again with big screws instead of bone graft and then advance to PNS after that.

 

[lobelsteve]

You guys should just get the bank account numbers and routing numbers for their insurance so you can take the money directly out. This way no one has to actually have anything done. You just take the money.

 

[Spartyon]

Nope, it doesn't

From my understanding 1.5 Tesla MRI is ok. 3T would be contraindicated.

 

[NJPAIN]

The cluneal nerves are good after failed SIJ fusions, but make sure they fail the fusion first. Counsel patients, "If this doesn't work, we'll do that; and if that doesn't work, we'll do this..."

But NEVER give up. There is always “microdosing” with a pump and some Percocet to take the edge off. After all you are Pain Management. We should re-name the specialty. “Last resort home for the ruptured, crippled or otherwise abandoned”.

 

[ateria radicularis magna]

But NEVER give up. There is always “microdosing” with a pump and some Percocet to take the edge off. After all you are Pain Management. We should re-name the specialty. “Last resort home for the ruptured, crippled or otherwise abandoned”.

Is pump microdosing BS? Honestly asking.

 

[BobBarker]

No. I have a friend who does it. It works with the right patient selection.

 

[NJPAIN]

Apologies for sidetracking the thread into MICRODOSING. Have a look at the attached files and decide for yourself. The first article is a case managed by one of microdosing's biggest proponents. This is pulled from the UofK website so I would assume that this is one of their "homeruns".

 

[clubdeac]

I went to the training for this. Appears to easy and not sure how stimulating one medial branch for 60 days can rid the patient of back pain for months to years. The guys at Wake love it and are doing it on everyone and their brother

 

[TIVAndy]

I went to the training for this. Appears to easy and not sure how stimulating one medial branch for 60 days can rid the patient of back pain for months to years. The guys at Wake love it and are doing it on everyone and their brother

tenderize the multifidus for 60 days?

 

[Orin]

I went to the training for this. Appears to easy and not sure how stimulating one medial branch for 60 days can rid the patient of back pain for months to years. The guys at Wake love it and are doing it on everyone and their brother

Are they still with Wake? I thought CPI was now private since WF brought that academic dude in?

I'm told it "reverses central sensitization" by one of their speakers, but who cares if it pays, I mean works right?

 

[clubdeac]

Are they still with Wake? I thought CPI was now private since WF brought that academic dude in?

I'm told it "reverses central sensitization" by one of their speakers, but who cares if it pays, I mean works right?

Yeah, I think you're right. They went independent. I'm RVU based and I think it's like 5 wRVUs or something like that

 

[DoYouEvenLiftBro]

How is this different than field stim?

 

[callmeanesthesia]

I went to the training for this. Appears to easy and not sure how stimulating one medial branch for 60 days can rid the patient of back pain for months to years. The guys at Wake love it and are doing it on everyone and their brother

Sounds similar to Mainstay, except you don’t have a big permanent battery and all. I guess the idea is the strengthen the multifidus. Might be a decent idea for pain that is worse with forward flexion. No idea how you’d program it though.

 

[Orin]

How is this different than field stim?

If CMS gets wise to it, it's technically percutaneous electrical nerve stimulation or percutaneous field stim.