Outcomes of Percutaneous and Paddle Lead Implantation for Spinal Cord Stimulation: A Comparative Analysis of Complications, Reoperation Rates, and Health-Care Costs

Babu, Ranjith; Hazzard, Matthew; Huang, Kevin T.; Ugiliweneza, Beatrice; Patil, Chirag G.; Boakye, Maxwell; Lad, Shivanand P.

doi:10.1111/ner.12065

Cited by 107 publications

(86 citation statements)

References 22 publications

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“…6,20 Because we performed paddle lead SCS implantation after confirming the efficacy with percutaneous SCS implantation, it is difficult to compare the efficacy and complications of these 2 types of hardware. However, an earlier report 1 showed that the overall (> 5 years) reoperation rate was approximately 3 times higher in percutaneous lead SCS implantation (22.9% vs 8.5%). The complication rate was slightly higher in paddle lead SCS implantation (3.4% vs 2.2%).…”

Section: Revision Timelinementioning

confidence: 95%

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Bir¹,

Konar²,

Maiti³

et al. 2016

FOC

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OBJECTIVE Spinal cord stimulators (SCSs) appear to be safe and efficacious for chronic intractable back pain. Although there are many reports on percutaneous SCSs, there are very few studies on outcomes of paddle lead SCSs. In addition, the predictors of requirement for SCS revision have not been well established. Here, the authors review the outcome of a case series and attempt to identify the predictors of SCS revisions. METHODS The clinical and radiological information of 141 patients with intractable chronic pain who underwent SCS implantation within the past 20 years was retrospectively reviewed. Paddle lead SCSs were used in this series. Statistical analysis was conducted using Kaplan-Meier curves and Cox proportional-hazards regression. RESULTS Among 141 cases, 90 (64%) did not require any revision after SCS implantations. Removal of the SCS was required in 14 patients. The average pain score was significantly reduced (preimplantation score of 8 vs postimplantation score of 1.38; p < 0.0001). Younger age, male sex, obesity, a preimplantation pain score ≥ 8, and the presence of neuromuscular pain were identified as predictors of the overall requirement for SCS revision. However, only a preimplantation pain score ≥ 8 was identified as a predictor of early failure of the SCS. CONCLUSIONS Implantation of a paddle lead SCS is a relatively less invasive, safe, and effective procedure for patients with intractable back pain. Revision of the procedure depends on many factors, including younger age, male sex, associated neuromuscular pain, and severity of the pain. Therefore, patients with these factors, for whom implantation of an SCS is planned, should be closely followed for the possible requirement for revision.

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Section: Revision Timelinementioning

confidence: 95%

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Bir¹,

Konar²,

Maiti³

et al. 2016

FOC

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“…The method of electrode implantation, surgeon familiarity with degenerative or complicated anatomy, specialty of proceduralist, and experience with each respective procedure will potentially affect the rate of complications. 1 Still, the literature has only a single report of spinal cord injury after cSCS. The present study reveals that there may be publication bias resulting in an underreporting of spinal cord injury after cSCS.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of 395 patients undergoing non-cervical-specific SCS lead implantations, an immediate index hospitalization neurological complication rate of 0.51% was reported. 1 In another study using the FDA Manufacturer and User Facility Device Experience database, Levy and colleagues reported that 239 (0.54%) of a total 44,587 electrode implantation procedures were associated with a neurological complication. 22 This confirms that the rate of neurological and spinal cord injury after cSCS is greater than previously reported in the noncervical-specific SCS population.…”

Section: Discussionmentioning

confidence: 99%

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Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Chan¹,

Winkler²,

Jacques³

2016

SPI

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OBJECTIVE Cervical spinal cord stimulation (cSCS) is used to treat pain of the cervical region and upper extremities. Case reports and small series have shown a relatively low risk of complication after cSCS, with only a single reported case of perioperative spinal cord injury in the literature. Catastrophic cSCS-associated spinal cord injury remains a concern as a result of underreporting. To aid in preoperative counseling, it is necessary to establish a minimum rate of spinal cord injury and surgical complication following cSCS. METHODS The Nationwide Inpatient Sample (NIS) is a stratified sample of 20% of all patient discharges from nonfederal hospitals in the United States. The authors identified discharges with a primary procedure code for spinal cord stimulation (ICD-9 03.93) associated with a primary diagnosis of cervical pathology from 2002 to 2011. They then analyzed short-term safety outcomes including the presence of spinal cord injury and neurological, medical, and general perioperative complications and compared outcomes using univariate analysis. RESULTS Between 2002 and 2011, there were 2053 discharges for cSCS. The spinal cord injury rate was 0.5%. The rates of any neurological, medical, and general perioperative complications were 1.1%, 1.4%, and 11.7%, respectively. There were no deaths. CONCLUSIONS In the largest series of cSCS, the risk of spinal cord injury was higher than previously reported (0.5%). Nonetheless, this procedure remains relatively safe, and physicians may use these data to corroborate the safety of cSCS in an appropriately selected patient population. This may become a key treatment option in an increasingly opioid-dependent, aging population.

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“…reportaron una alternativa percutánea segura para el implante de EP (7). Los reportes de reoperación mediante laminectomía después de implante del EP han sido asociados principalmente a la migración o disfunción del EP por fractura (8).…”

Section: Discussionunclassified

Técnica de recambio de electrodo percutáneo disfuncional para estimulación medular como tratamiento del dolor crónico refractario en paciente con Schwannoma de raíz L2 izquierda: reporte de caso

Criollo-Muñoz

Hernández-Santos

Román-Echavarría

2017

Rev. Soc. Esp. Dolor.

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Artículo Aceptado para su pre-publicación / Article Accepted for prepublication Título / Title: Técnica de recambio de electrodo percutáneo disfuncional para estimulación medular como tratamiento del dolor crónico refractario en paciente con Schwannoma de raíz L2 izquierda: reporte de caso / Disputal percutaneal palette replacement technique for medular stimulation as a treatment of refractory chronic pain patient without Schawannoma L2 left: case report Este es un archivo PDF de un manuscrito inédito que ha sido aceptado para su publicación en la Revista de la Sociedad Española del Dolor. Como un servicio a nuestros clientes estamos proporcionando esta primera versión del manuscrito en estado de prepublicación. El manuscrito será sometido a la corrección de estilo final, composición y revisión de la prueba resultante antes de que se publique en su forma final. Tenga en cuenta que durante el proceso de producción se pueden dar errores lo que podría afectar el contenido final. El copyright y todos los derechos legales que se aplican al artículo pertenecen a la Revista de la Sociedad Española de Dolor. TÉCNICA DE RECAMBIO DE ELECTRODO PERCUTÁNEO DISFUNCIONAL PARA ESTIMULACIÓN MEDULAR COMO TRATAMIENTO DEL DOLOR CRÓNICO REFRACTARIO EN PACIENTE

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Outcomes of Percutaneous and Paddle Lead Implantation for Spinal Cord Stimulation: A Comparative Analysis of Complications, Reoperation Rates, and Health-Care Costs

Cited by 107 publications

References 22 publications

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Técnica de recambio de electrodo percutáneo disfuncional para estimulación medular como tratamiento del dolor crónico refractario en paciente con Schwannoma de raíz L2 izquierda: reporte de caso

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