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Permanent Paddle-lead Trial for Spinal Cord Stimulation
Jonathan J Lee1, Richard K Simpson1, Brian Dalm1
1Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, USA.
Cureus
|July 24, 2018
Summary
Surgically implanted paddle-lead trials offer a safe and effective alternative for chronic pain patients unsuitable for percutaneous spinal cord stimulation (SCS) trials. This method demonstrated success without complications in select patient groups.
Area of Science:
- Neurosurgery
- Pain Management
- Medical Devices
Background:
- Chronic pain affects many patients, with spinal cord stimulation (SCS) being a key treatment.
- Percutaneous electrode screening trials are standard for predicting SCS success.
- Some patients are poor candidates for traditional percutaneous trials.
Purpose of the Study:
- To report the initial experience with surgically implanted paddle-lead SCS trials.
- To evaluate the safety and efficacy of paddle-lead trials in patients ineligible for percutaneous trials.
Main Methods:
- Retrospective review of 12 patients undergoing surgically implanted paddle-lead trials (2014-2017).
- Success defined as a 50% reduction in pain rating.
- Positive trials led to a second surgery for pulse generator internalization.
Main Results:
- All 12 patients achieved successful trial outcomes (≥50% pain reduction).
- No paddle-lead migrations or infections were reported.
- Only one patient required surgical removal of the SCS system after nine months.
Conclusions:
- Surgically implanted paddle-lead trials are a safe and effective alternative for patients unsuitable for percutaneous trials.
- This approach resulted in no complications and successful internalization surgeries for all patients.
- Failure in percutaneous trials may not exclude patients from SCS benefits.
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