Case SeriesA Novel Technique for the Implantation of Paddle Leads in the Cervical Spine
Section snippets
INTRODUCTION
Neuromodulation has been used successfully to treat many chronically painful conditions, such as failed back surgery syndrome (1), chronic regional pain syndrome (2), and ischemic limb pain (3). The technique for introducing permanent spinal cord paddle stimulator leads in the thoracic spine is well established (4). With the success of neuromodulation for painful conditions of the back and lower extremities has come interest in using these devices for similar conditions in the neck and upper
MATERIALS AND METHODS
This is a case series review of the author’s experience with the implantation of permanent spinal cord stimulator paddle leads in the cervical spine specifically looking at mechanical failures. From January 2009 to January 2012, 545 spinal cord stimulator paddle leads were either inserted or revised by the author. Of these, 513 were implanted in the thoracic spine, and 34 were implanted in the cervical spine.
RESULTS
There were no dural tears, cerebrospinal fluid (CSF) leaks or neurologic complications in this series. All wounds, except one (an infection), healed primarily without incident. Eleven (32%) of the 34 patients required removal or revision of their cervical spinal cord stimulators within one month of insertion. Six (40%) of the 15 patients with a Boston Scientific lead required removal or revision. One was removed for infection. This was an unusually long procedure due to difficulty positioning
DISCUSSION
There is not much literature devoted to cervical spinal cord stimulation. The majority that does exist deals with the implantation of percutaneous leads. Most of the remaining papers lump thoracic and cervical implants together. Details of the surgical technique used and the complications are not distinguished between the thoracic groups and the cervical groups.
Displacement of the stimulator leads is not an uncommon cause of failure of cervical spinal cord stimulation. Robaina et al. (5)
Authorship Statement
Dr. Amrani was the sole author of this submission and responsible for the manuscript and data presented.
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Phoenix, AZ, USA