The Prospective Evaluation of Safety and Success of a New Method of Introducing Percutaneous Paddle Leads and Complex Arrays With an Epidural Access System

Deer, Timothy R.; Bowman, Richard; Schocket, S. Matthew; Kim, Christopher; Ranson, Matthew T.; Amirdelfan, Kasra; Raso, Louis J.

doi:10.1111/j.1525-1403.2011.00419.x

Cited by 23 publications

(17 citation statements)

References 6 publications

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“…In a systematic review of 180 cSCS patients across 10 studies with up to 88 months of follow-up after cSCS, the rate of hardware malfunction (17.8%), lead migration (13.9%), lead fracture (6.7%), pain over implant site (4.4%), infection (2.2%), over-or understimulation (1.1%), intermittent stimulation (0.5%), and other complications (8.3%) with the absence of any neurological injury supports a low long-term risk of cSCS. 6 Studies that have evaluated non-cervicalspecific SCS have also supported its cost-effectiveness in treating pain. 17 Lumbar SCS for chronic pain after failed back surgery syndrome has been associated with improved outcomes 19,27 and decreased complications-without an increase in cost 26 -relative to lumbar reoperation.…”

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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Section: Discussionmentioning

confidence: 99%

“…A Tuohy needle had been placed at the T-3 interspace resulting in an inadvertent intramedullary placement of an electrode, with the distal tip at the level of C-2. There is report of significant injury in noncervical spinal cord stimulation, [1][2][3]6,12,13,15,22,29,32 but a paucity of literature studying such injuries in the cervical population.…”

mentioning

confidence: 99%

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

Chan¹,

Winkler²,

Jacques³

2016

SPI

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“…. Recent years have seen a transformation of technology, including percutaneous paddle leads, adaptive stimulation, new multicontact arrays, and improved programming platforms .…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of Dorsal Root Ganglion Stimulation for the Relief of Chronic Pain

Deer¹,

Grigsby

Weiner

et al. 2013

Neuromodulation: Technology at the Neural Interface

187

164

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“…Many physicians prefer to implant a generous number of electrodes, as the pain pattern may change or the lead can migrate; thus, if this occurs, it can be solved electronically. [2383108126127]…”

Section: Hardware and Programming Parametersmentioning

confidence: 99%

“…However, it is possible to introduce a paddle-type one by using a tubular retractor system under local anesthesia. [61423425166738183108127134145161] At present, the indications of SCS are being revised constantly, while new applications are being proposed and researched worldwide. Spinal cord stimulation is the most frequently applied neuromodulation method.…”

Section: Introductionmentioning

confidence: 99%

Dorsal column stimulator applications

Yampolsky¹,

Hem²,

Bendersky³

2012

Surg Neurol Int

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Background:Spinal cord stimulation (SCS) has been used to treat neuropathic pain since 1967. Following that, technological progress, among other advances, helped SCS become an effective tool to reduce pain.Methods:This article is a non-systematic review of the mechanism of action, indications, results, programming parameters, complications, and cost-effectiveness of SCS.Results:In spite of the existence of several studies that try to prove the mechanism of action of SCS, it still remains unknown. The mechanism of action of SCS would be based on the antidromic activation of the dorsal column fibers, which activate the inhibitory interneurons within the dorsal horn. At present, the indications of SCS are being revised constantly, while new applications are being proposed and researched worldwide. Failed back surgery syndrome (FBSS) is the most common indication for SCS, whereas, the complex regional pain syndrome (CRPS) is the second one. Also, this technique is useful in patients with refractory angina and critical limb ischemia, in whom surgical or endovascular treatment cannot be performed. Further indications may be phantom limb pain, chronic intractable pain located in the head, face, neck, or upper extremities, spinal lumbar stenosis in patients who are not surgical candidates, and others.Conclusion:Spinal cord stimulation is a useful tool for neuromodulation, if an accurate patient selection is carried out prior, which should include a trial period. Undoubtedly, this proper selection and a better knowledge of its underlying mechanisms of action, will allow this cutting edge technique to be more acceptable among pain physicians.

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The Prospective Evaluation of Safety and Success of a New Method of Introducing Percutaneous Paddle Leads and Complex Arrays With an Epidural Access System

Cited by 23 publications

References 6 publications

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

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

A Prospective Study of Dorsal Root Ganglion Stimulation for the Relief of Chronic Pain

Dorsal column stimulator applications

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