Faculty Collaboration Database

Incidence of Revision Surgery in a Large Cohort of Patients With Thoracic Surgical Three-Column Paddle Leads: A Retrospective Case Review. Neuromodulation 2015 Jul;18(5):367-75

Date

09/25/2014

Pubmed ID

25251044

DOI

10.1111/ner.12239

Scopus ID

2-s2.0-84934765478 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

OBJECTIVES: Spinal cord stimulation (SCS) revision surgery remains common, with a negative impact on cost-effectiveness and outcomes. The primary goal in this report was to retrospectively study the need for revision surgery in a large cohort of patients with newly implanted thoracic surgical three-column paddle leads, focusing on a method of implantation to reduce the need for revision surgery. Clinical outcomes were also assessed.

METHODS: The outcomes in 126 patients who received initial surgical paddle SCS implants for back and/or leg pain from 2008 to 2012 were retrospectively analyzed. A disinterested third party performed chart reviews and telephone interviews. A single surgeon with a consistent method performed all implants, with no lead anchoring. All three major commercial vendors were utilized.

RESULTS: There were no paddle electrode lead revisions required for spontaneous fracture, migration, or infection at an average chart-review follow-up period of 20 months. With subsequent telephone interviews, a 65% clinical success rate was seen at 29 months. Significant suboptimal stimulation with body-position changes (SSBPC) was reported in less than 10% of patients. All results were vendor-independent.

CONCLUSIONS: This report, the largest to date on patients with three-column paddle leads, shows low electrode revision rates with expected clinical success rates. Clinically relevant SSBPC was uncommon.

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

Adolescent
Cohort Studies
Electrodes, Implanted
Female
Humans
Incidence
Low Back Pain
Male
Middle Aged
Neurosurgical Procedures
Pain Measurement
Spinal Cord Stimulation
Treatment Outcome