Which leads are the easiest to steer?

[Pain Applicant1]

I mostly use Boston Science for my trials but I find them difficult to drive and steer. I find it really difficult to turn the stylet. Anyone have any opinions on which leads move the smoothest?

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[pmrmd]

I like Medtronic leads alot. SJM are nice but they are a little long and I feel like I have a garden hose in my hand.

 

[clubdeac]

I always thought BS were the easiest to steer

 

[lobelsteve]

Leads in young crps patients are easier to steer than in crusty old 722.83 patients.

 

[jj337]

I find that whatever one you trained on is the easiest to drive

 

[Ducttape]

Paddle leads under open thoracotomy..

Honestly, i do like Medtronic the best - because i like the stylet the best. the BS seems so flimsy, and the StJ ones seem to almost break...

 

[mdvol]

BS seem easier to me.

 

[LordArius]

BS seem easiest to me.

 

[PinchandBurn]

i always thought bs were the easiest to steer

+1

 

[Aether2000]

BS>SJ>>MDT. Use all three systems.

 

[bedrock]

BS>SJ>>MDT. Use all three systems.

I"m sure you've used all three systems by now, but why would you continue using all 3 indefinitely?

Haven't you decided which one you preferred?

 

[Ducttape]

I"m sure you've used all three systems by now, but why would you continue using all 3 indefinitely?

Haven't you decided which one you preferred?

Why not use all 3? There are subtle differences that can be exploited...

 

[clubdeac]

Why not use all 3? There are subtle differences that can be exploited...

pray tell... what are the most notable differences and when would exploit one over the other? This will be a good review

 

[joshmir]

shoulder issues- BS with remote control may offer better advantage if IPG placed in the back

need for brain imaging- is MDT the only one approved for brain imaging?

StJ- perc paddle better for better axial coverage?

 

[Ducttape]

pray tell... what are the most notable differences and when would exploit one over the other? This will be a good review

its all marketing by the companies, i admit, (with the exception possibly of the lunches)

but the ones joshmir lists, and also:

RestoreSensor for positional changes by Medtronic.

Non-Medtronic systems if your patient is absentminded and you are worried he will forget to recharge (have had at least 2 patients in my limited 5 year pain experience need it changed because battery ran completely dry)

i dont use it, but maybe Epiducer?

i havent done this, but do have a patient with 2 separate pain issues that might benefit from 2 separate arrays, so maybe St. Jude for its 16 contacts...

 

[Aether2000]

Boston is great for patients that have trouble reaching behind them due to limitations of shoulder motion, has great programability. S leads from StJ are unidirectional which has been shown to reduce lig flavum stimulation induced back pain in some, and a wide electrode that does not move in a capacious canal. MDT is the only one approved for patients needing brain MRIs and the positional change gyro is kewl/ works well...and is better in patients that have jobs that require frequently changing positions.

 

[Ligament]

I use all three companies. It is better to keep competition up to drive down prices and encourage innovation. Also, reps come and go so good to be familiar with multiple. Also, any rep/company will take you for granted if you use them exclusively, unless you are a heavy hitter lecturer/researcher for them.

 

[dc2md]

I have only used Boston and Medtronic. Boston are far far easier to steer than Medtronic, which are too flimsy.

 

[clubdeac]

which ones have the battery that dies if left to completely discharge, I forget, both medtronic and boston?

 

[Ducttape]

Medtronic.

 

[Axehandler]

No problems steering Medtronic. Best prior authorization service-Medtronic, best customer service-Medtronic, Restore Sensor-Medtronic, MRI brain compatible-Medtronic

How can you justify putting in a system that has no MRI compatibility when you know one that allows for at least limited compatibility exists?

 

[Aether2000]

MDT has very limited mri compatibility, marginal programmability, and steers well only over short distances. There are good reasons not to use medtronic in some circumstances. Customer service is dependent on the reps themselves.

 

[nhl23]

No problems steering Medtronic. Best prior authorization service-Medtronic, best customer service-Medtronic, Restore Sensor-Medtronic, MRI brain compatible-Medtronic

How can you justify putting in a system that has no MRI compatibility when you know one that allows for at least limited compatibility exists?

Medtronic's MRI Labeling has several limitations, there are too many variables to ensure patient safety to classify their SCS as "MRI compatible". It is labled as head only with many caveats. In fact, this head only labeling can be obtained by any manufacturer that wants it. Boston is approved in Europe for head only scans. Many of the raw components of all manufacturers are sourced from the same suppliers. Medtronic just pursued to have it on their labeling.

For me it is Boston first for many reasons, mainly because the rep is very good, they have the best programming platform , most efficient in the OR, completely wireless, and to answer the original question of this thread, the leads do steer better for me. I also use Medtronic , but never because of the limited MRI compatibility, and I don't use St. Jude.

All systems have their merits and shortcomings. It is good to be familiar with them all and match the right system to the patient needs.

 

[painstop]

nhl23, I don't like to besmirch other people without knowing them but I STRONGLY suspect you are a Boston rep troll. Your only other contrbution to this forum was about the St. Jude recall for Eon-mini...unless all you do every day in your "pain clinic" is SCS then I will call an a spade a spade and take your "advice" at face value... I for one have never researched the raw materials used in these systems but I suspect it was taught to you at your yearly Boston Scientific retreat

PS - I have no problem with Boston Scientific personally and find they do have excellent programmability