A novel technique for the implantation of paddle leads in the cervical spine

Electrical spinal cord stimulators are routinely used in the thoracic spine for back and lower extremity pain. The anatomy of the cervical spine differs significantly from that of the thoracic spine and deserves special considerations if these implants are to be inserted safely in the neck. This paper explores the technical challenges of implanting paddle leads in the cervical spine and offers a novel technique for implantation.

Thirty-four patients underwent implantation of permanent spinal cord stimulators in the cervical spine by the same surgeon. The ages ranged from 26 to 59 with an average age of 45 years. Fifty-three percent of the patients were female, and 47% were male. Nineteen patients received St. Jude Exclaim leads; 15 patients received Boston Scientific Artisan leads. Mechanical failure of the device was the end point.

Eleven of the 34 patients (32%) required removal or revision of the device for mechanical failure. Forty percent of the Boston Scientific patients had mechanical failures compared with 25% of the St. Jude patients (p = 0.73). When the Boston Scientific patients were compared with the St. Jude patients with the newer technique of implantation (mechanical failure = 0), the p value was 0.06.

A new technique is presented that allows easy and reliable implantation of cervical paddle leads in the neck with a low risk of iatrogenic complications.