Uncomfortable Paresthesia and Dysesthesia Following Tonic Spinal Cord Stimulator Implantation

Background/Objectives: To determine the incidence of and risk factors for uncomfortable paresthesia and/or dysesthesia after tonic percutaneous spinal cord stimulator implantation. Methods: A retrospective analysis was conducted on the prospectively collected data of patients that had permanent percutaneous tonic spinal cord stimulators implanted. Our primary objective was to assess the prevalence of complications over a period of 24 months after the implantation of this device. Results: The mean post-implantation follow-up time was 27.3 months. The mean pain score before spinal cord stimulator implantation was 8.05, which was reduced to 3.6 after 24 months. The most common complications in our study sample were the need for revision and the development of unpleasant paresthesia, which were reported by 34.95% and 27.86% of patients, respectively. There was no association between paresthesia and age, sex, or body mass index (BMI). The only risk factor of statistical significance was current tobacco use (p = 0.001). Conclusions: The development of uncomfortable paresthesia after SCS is associated with considerable morbidity, particularly the explantation of SCS, despite adequate pain relief. Focusing on strategies, such as appropriate waveform selection, might reduce the incidence of uncomfortable paresthesia requiring revision or explantation. Current tobacco use appears to be a significant risk factor for the development of unpleasant paresthesia/dysesthesia when compared with non-tobacco and former tobacco users after tonic percutaneous spinal cord stimulator implantation.