Curonix was Stimwave

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lobelsteve

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Magic beans?


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I don’t buy it. PNS never worked before.

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Lots of magic beans in pain medicine, why do you not like this one specifically?

PNS (Temporary abolition of pain in man - PubMed) worked before SCS (Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report - PubMed) did, but it didn't commercialize well due to the hardware issues. Even them though, off label SCS hardware used to work great until it moved, broke, eroded in my experience.

With that said, I'd rather RFA a knee than stim it.
 

Magic electrons.

Next up:


  • Second Quarter 2023 Net Loss from Operations of $25.6 Million; Second Quarter 2023 Non-GAAP Adjusted EBITDA Loss of $3.1 Million
 
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Magic electrons.

Next up:


  • Second Quarter 2023 Net Loss from Operations of $25.6 Million; Second Quarter 2023 Non-GAAP Adjusted EBITDA Loss of $3.1 Million
Glad I am risk averse. Index funds for me.
 
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I’ve done four PNS geniculate stim implants with Nalu over the last 4 months. All 40-70% improved over baseline. All failed TKRs. All miserable before not so much now.
 
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I’ve done four PNS geniculate stim implants with Nalu over the last 4 months. All 40-70% improved over baseline. All failed TKRs. All miserable before not so much now.
Private practice or hospital?
 
I’ve done four PNS geniculate stim implants with Nalu over the last 4 months. All 40-70% improved over baseline. All failed TKRs. All miserable before not so much now.

Next time try squirting some phenol on the genicular nerves and tell me what happens.


 
i'm working on manuscript of 10 cases also. 1-2 year post implant data. all post TKA pain who failed genicular RFAs
 
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@lobelsteve have you explored academic pain medicine where non-interventionalists pontificate about central pain and claim no intervention works?

(Kidding)
 
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Did tons of PNS in the L8680 days. Man did my boss make great money. Theatric placebo (cue drusso).
Crappy literature.

Anyone catch on to how new procedures are developed?

1. Company gets investment capitol.
2. Company creates a new procedure/device
3. Company hires KOL to tell us how wonderful it is.
4. Company funds KOL to do research controlled by company with poor study design.
5. Some folks start doing procedure and results are amazing.
6. No one talks about failures.
7. No one does independent research.
8. It doesn't work.

Pain is a bunch of ****** in pointy toed shoes trying to out do each other. Just check out LinkedIn, the bragging grounds where there are daily tryouts to become the next Timmy.
 
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True. I don’t believe the hype from the talking heads etc, we will see how these pan out long term, for select patients it’s seems to be a reasonable option with the current technology. I don’t think you can equate previous attempts at PNS with the current systems.
 
Did tons of PNS in the L8680 days. Man did my boss make great money. Theatric placebo (cue drusso).
Crappy literature.

Anyone catch on to how new procedures are developed?

1. Company gets investment capitol.
2. Company creates a new procedure/device
3. Company hires KOL to tell us how wonderful it is.
4. Company funds KOL to do research controlled by company with poor study design.
5. Some folks start doing procedure and results are amazing.
6. No one talks about failures.
7. No one does independent research.
8. It doesn't work.

Pain is a bunch of ****** in pointy toed shoes trying to out do each other. Just check out LinkedIn, the bragging grounds where there are daily tryouts to become the next Timmy.

Do you think nevro scs works?
 
Do you think nevro scs works?
I use Nevro not infrequently, but IMO (not that you asked me) it is inferior to Abbott.

Especially now that Abbott launched Eterna, I am not sure how much longer I'll offer Nevro (or BSc). It seems I have more frustrated Nevro pts than Abbott.
 
I use Nevro not infrequently, but IMO (not that you asked me) it is inferior to Abbott.

Especially now that Abbott launched Eterna, I am not sure how much longer I'll offer Nevro (or BSc). It seems I have more frustrated Nevro pts than Abbott.
The other way around.
 
Some of the relative success or failures seem to be rep dependent in my experience. I’m venturing down the closed loop path right now. Will be interesting to see if real life is close to study data
 
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I use Nevro not infrequently, but IMO (not that you asked me) it is inferior to Abbott.

Especially now that Abbott launched Eterna, I am not sure how much longer I'll offer Nevro (or BSc). It seems I have more frustrated Nevro pts than Abbott.
I was poking a little fun @lobelsteve bc in my opinion this “new procedure” follows his steps very elegantly
 
I do not even know what is going on.
I guess my unsuccessful attempt to suggest nevro scs follows the same path that you described quite well.

I’d also add that I don’t think we will see new treatment options or technology follow any other pathway than this in today’s day and age. The desire for new options (whatever the motive may be) and the need for it will always outpace the speed at which proper non-sponsored research can keep up with.
 
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Seeing Curonix more visible now on social media and I know some physicians using it. I'd love to know how they managed to pivot. Is the technology different now? Anyone have experience?


Also, the story of the fraud is sad and fascinating. Did this one CEO somehow act alone to make a plastic stylet? Did no one else know? Were all the reps and other execs and engineers completely in the dark? Someone needs to do a long form deep dive on this story.
 
I've only done one Genicular PNS (Nalu) and that was for a patient who developed severe neuropathic pain in her knee after TKA. The patient reported considerable pain relief after implant. I haven't heard from them in over 6 months. But there was no good location to place the disc and in my opinion, it is an impractical system due to inadequate good placing for the disc (which is also quite bulky. In the end, I kinda wished I just did DRG/SCS.
 
 
Seeing Curonix more visible now on social media and I know some physicians using it. I'd love to know how they managed to pivot. Is the technology different now? Anyone have experience?


Also, the story of the fraud is sad and fascinating. Did this one CEO somehow act alone to make a plastic stylet? Did no one else know? Were all the reps and other execs and engineers completely in the dark? Someone needs to do a long form deep dive on this story.
Tech is still the same
They're cutting pricing relative to competitor products so more usage

Supposedly some folks did push back but not sure those people are still with the company
It would be a good documentary

I'm not sure how they're still using their codes with the new PNS code. They say it doesn't apply to them, but it seems to be precisely written for them. Bioventus uses it as it is more $$ than a 64555 but it's less than 64555+64590 for a PNS and generator which Stimwave/Curonix uses.

64596INSERTION OR REPLACEMENT OF PERCUTANEOUS ELECTRODE ARRAY, PERIPHERAL NERVE, WITH INTEGRATED NEUROSTIMULATOR, INCLUDING IMAGING GUIDANCE, WHEN PERFORMED; INITIAL ELECTRODE ARRAY
 
I’ve found insurance coverage to be so poor that I’m surprised the peripheral nerve stimulators are still in business

They are spending a ton of dollars advertising it to doctors. At the Texas pain society meeting every case presentation was a Sprint PNS implant
 
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