Synergetic efficacy of simultaneous DRG- and traditional spinal cord stimulation

Piedade, Guilherme Santos; Vesper, Jan; Slotty, Philipp J.

doi:10.1007/s00701-019-04166-y

Cited by 11 publications

(7 citation statements)

References 4 publications

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“…One trial was successful; therefore, the external extensions were removed, and the pulse generator was implanted 13,14 . As a matter of fact, some authors do not think of the placement of SCS paddles as a rescue therapy after failed percutaneous 17 and others use different waveforms for complex cases 18 . Depending on the patient's anatomy, paddle placement would be the primary choice for trial and permanent implant.…”

Section: Discussionmentioning

confidence: 99%

Retrograde thoracic spinal cord stimulation paddle placement for complex persistent spinal pain syndrome type 2

de Monaco,

Piedade,

Doomi

et al. 2023

Pain Practice

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BackgroundSpinal cord stimulation (SCS) is a cost‐effective option for treating refractory persistent spinal pain syndrome type‐2 (PSPS‐2). For patients with extensive spine instrumentation including the thoraco‐lumbar junction, percutaneous placement of SCS leads is usually not an option being paddle leads typically implanted anterograde. Paddle lead placement will be particularly challenging in more complex cases when the instrumentation covers the targeted level. To overcome this barrier, we studied using a retrograde approach to reach the sweet spot, facilitate the placement, and reduce associated risks.ObjectivesTo study the use of retrograde SCS paddle as a placement method to optimize the spinal cord target and reduce the risks of conventional placement in complex cases.Study DesignCase series and technical note.MethodsWe present three cases of thoracic retrograde SCS paddle lead placement cases, detailing patient selection, operative technique, and outcome. All the cases had extensive instrumentation to the thoraco‐lumbar spine, and one had additional spinal canal stenosis. The surgical procedure entailed a retrograde midthoracic inter‐laminar approach, flavectomy, and caudal placement of the paddle lead with intraoperative neurophysiologic monitoring (IONM) guidance for functional midline determination.ResultsAll the cases had a successful lead placement over the sweet spot without complications. The same approach was used to decompress a focal spinal stenosis in one case. One case had significantly improved pain and hence underwent a pulse generator implant. The other cases had non‐satisfactory pain control and were explanted.LimitationsThese case description could guide technical procedural steps, however, a larger number of such cases would be needed to describe further technical nuances.ConclusionsWe demonstrated that placing SCS paddle leads via retrograde midthoracic approach with IONM guidance is safe. This procedure should be an option for SCS paddle implants in patients with posterior spinal fusion encompassing the intended targeted spinal stimulation level.

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Section: Discussionmentioning

confidence: 99%

Retrograde thoracic spinal cord stimulation paddle placement for complex persistent spinal pain syndrome type 2

de Monaco,

Piedade,

Doomi

et al. 2023

Pain Practice

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“…9 The potential that combination therapy with tonic-SCS and DRGS may be beneficial in patients with severe and refractory CRPS. 10,11 Data from the ACCURATE study suggest that DRGS could be used in patients suffering from chronic intractable pain conditions that are refractory to tonic-SCS. 12 Unilateral epidural stimulation is an effective type of SCS in the treatment of pain syndromes.…”

Section: Discussionmentioning

confidence: 99%

Epidural unilateral stimulation with “adaptive stim” option in treatment of type II CRPS

Simonyan

Tyurnikov

Simonyan³

et al. 2022

Clinical Case Reports

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“…10 The potential that combination therapy with t-SCS and DRG-S may be beneficial in patients with severe and refractory CRPS. 11,12 Data from the ACCURATE study suggests that DRGS could be used in patients suffering from chronic intractable pain conditions that are refractory to t-SCS. 13 Unilateral epidural stimulation is an effective type of SCS in the treatment of pain syndromes.…”

Section: Discussionmentioning

confidence: 99%

Epidural unilateral stimulation with “Adaptive Stim” option in treatment of type II CRPS

Simonyan

Tyurnikov²,

Simonyan

et al. 2021

Preprint

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Synergetic efficacy of simultaneous DRG- and traditional spinal cord stimulation

Cited by 11 publications

References 4 publications

Retrograde thoracic spinal cord stimulation paddle placement for complex persistent spinal pain syndrome type 2

Retrograde thoracic spinal cord stimulation paddle placement for complex persistent spinal pain syndrome type 2

Epidural unilateral stimulation with “adaptive stim” option in treatment of type II CRPS

Epidural unilateral stimulation with “Adaptive Stim” option in treatment of type II CRPS

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