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Real-Time Pressure Sensing Is Associated With Reduced Complication Rates in Percutaneous Spinal Cord Lead
Sean O'Leary1, Anthony M Price2, Christopher File1
1Department of Neurosurgery, University of Texas Medical Branch, Galveston , Texas , USA.
Operative Neurosurgery (Hagerstown, Md.)
|May 4, 2026
Summary
CompuFlo real-time pressure feedback for spinal cord stimulator (SCS) implantation reduced perioperative complications. This technique identified the epidural space effectively without increasing needle passes or hospital stay.
Area of Science:
- Neurosurgery
- Anesthesiology
- Medical Devices
Background:
- Accurate identification of the epidural space is crucial for spinal cord stimulator (SCS) implantation.
- Traditional methods like loss of resistance can be subjective and may lead to complications.
Purpose of the Study:
- To evaluate the efficacy and safety of CompuFlo, a real-time pressure monitoring system, for epidural access during SCS procedures.
- To compare CompuFlo-guided epidural access with the standard loss of resistance technique.
Main Methods:
- A single-center retrospective cohort study compared consecutive SCS implantations using CompuFlo versus standard loss of resistance.
- The primary outcome was a composite of cerebrospinal fluid leak, epidural blood patch, or postoperative radiculopathy.
- Secondary outcomes included needle-pass burden, operative time, and length of stay, with models adjusted for patient demographics.
Main Results:
- CompuFlo guidance was associated with significantly lower adjusted odds of perioperative complications (aOR 0.09, P = .039).
- No significant differences were observed in needle-pass burden, operative time, or length of stay between the groups.
- Specific pressure readings from CompuFlo demonstrated distinct pre-epidural and epidural pressure profiles.
Conclusions:
- CompuFlo-guided epidural access during SCS implantation offers a potential safety benefit by reducing perioperative complications.
- The technique does not increase procedural burden in terms of needle passes or hospital length of stay.
- Further investigation through larger prospective studies is recommended to validate these findings.
