Faculty Collaboration Database

A Novel Nonanchoring Technique for Implantation of Paddle Leads in the Cervical Spine Under Conscious Sedation. Neuromodulation 2015 Aug;18(6):472-6; discussion 476-7

Date

03/27/2015

Pubmed ID

25809094

DOI

10.1111/ner.12283

Scopus ID

2-s2.0-84940373189 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVES: Spinal cord stimulation (SCS) revision surgery remains common, with a negative impact on cost-effectiveness and outcomes. The primary goal of this report was to retrospectively study the need for revision surgery in a cohort of complex regional pain syndrome type I (CRPS-1) patients with newly implanted cervical surgical paddle leads, focusing on a method of implantation to reduce the need for revision surgery.

METHODS: Fifteen patients underwent implantation of paddle SCS leads in the cervical spine with cervical laminotomies under conscious sedation for CRPS-1 from 2008 to 2012. Electrodes were not anchored and 11 of the electrodes were three-column paddle leads. A disinterested third party performed initial chart reviews, supplemented by subsequent telephone interviews. The need for revision surgery was the endpoint. A single surgeon performed all implants with a consistent method.

RESULTS: There were no paddle electrode lead revisions required for suboptimal lead placement, fracture, migration, or infection at a median follow-up period of 22 months.

CONCLUSIONS: This study is the first to report on: 1) cervical electrode implantation with no anchoring; and 2) cervical paddle lead implantation (including three-column paddles) performed under conscious sedation. The specific method of nonanchoring of the paddle implants under conscious sedation may have contributed to low electrode lead revision rates.

Author List

Pahapill PA

Author

Peter A. Pahapill MD, PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cervical Vertebrae
Cohort Studies
Complex Regional Pain Syndromes
Conscious Sedation
Electrodes, Implanted
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pain Measurement
Spinal Cord
Spinal Cord Stimulation
Treatment Outcome