Candidates/Current Patients
Who is a candidate?
Failed back surgery syndrome, Non-surgical back pain, diabetic peripheral neuropathy of the lower extremities, radiculopathy symptoms
- patients having on going pain after a surgery that would b expected to be gone
- Patients having joint replacements (etc. knees or hips). who have ongoing pain even though imaging looks great
Tonic vs BurstDR
Tonic: high density, high frequency, DTM, wavewriter, FAST, cycled tonic
BurstDR: 5 pulse train, non-linear charge accumulation, quiescent repolarization period, no active recharge needed, sub-perception, 10-40Hz & .25-1.5mA, Ca++ mediated plateau
Eterna
SMALLEST rechargeable IPG per volume currently on market
Little to no recharge burden - full to empty around 2 months with nominal settings
What is the FDA indication for DRG?
CRPS I - Budapest Criteria
CPRS II - Causalgia
- Surgery, fracture, sprain, burns or other peripheral nerve injury. Can you identify a specific nerve(s)
My Health Journey
App allows patient to have educational resources, they are assigned to a rep on the app, followed through course of the trial, provider recieves trial report or patient outcomes
POST IMPLANT: surerys sent 1/3/6/9/12 months, then every 3-6 months thereafter
Android and iPhone user
Who can they call for help?
Any of the team members
Tech SupportDoes it target pain the same as other therapies?
Lateral - physical response to pain
Medial - Emotional response to pain
Proclaim
Low Maintenance - primary cell option for those non-compliant with charging, elderly who have difficultly with charging, patients with a high BMI
1. Where can leads be placed?
2. How many leads can be used?
1. On label T10-S2
2. Up to 4 leads can be placed
Virtual Clinic
Ability to reprogram and run diagnostics remotely for any patient with our device with wifi within the United States
Free of charge for providers
Live facetime with an Abbott Representative
Name 5 characteristics of chronic pain
sharp
stabbing
shooting
burning
prickling
Why does calcium matter?
Mimics natural firing patterns in the body
Which battery is best for a patient?
Cognitive function, shoulder ROM, convenience, patient body composition are factors taken into consideration
What would I look for in a candidate?
Signs/Symptoms:
Focal pain, hyperalgesia/allodynia, skin changes (temperature/discoloration, localized edema
Can I trust the research?
YES! Abbott has the most level 1A evidence compared to any other SCS company
What do patients need to have done before having a SCS trial?
Workup needed by insurance
Thoracic MRI/
Psych evaluation
What is the difference between Nevro, Medtronic, Saluda, Boston Scientific, Biotronik
Nevro: High Frequency 10k Therapy
Medtronic:,DTM/Closed Loop. High Frequency. Primary function is to keep stimulation at the same intensity/reduce overstimulation
Saluda: old school paresthesia tonic. Low or high frequency
Boston: High Frequenecy and Low frequency. Wavewriter. No closed loop
Biotronik: High Frequency, multiphase tonic, typically 60-2400Hz
How big are the batteries?
Eterna:
H/L/T: 1.52", 1.89", .36"
Proclaim:
H/L/T: 2.19", 1.95", .53"
Eterna is currently the smallest IPG on the market with lowest recharge burden
How does it work?
Direct stimulation of the primary sensory nerve cell bodies regulates DRG misfiring
Stimulates in microAmps
What studies can I read?
4-year Reality Study: BurstDR longevity/Efficacy
(Burst)able: salvage from tonic
Triumph: psychometrics
Distinct: Non-Surgical back pain
When did Abbott acquire Saint Jude?
2016
Who created this?
Dr. Dirk De Ridder
He is a neurosurgeon in New Zealand
What are our batteries made from?
LITHIUM
Fun Fact: It is atomic #3
Are there any studies?
Accurate: DRG
Who is on the team?
Dave, Erinn, and Maddy
Evan and Stephen