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Accuracy, Repeatability, and Reproducibility of a Radiographic Technique to Assess Spinal Cord Stimulation Lead
Andrew Thoreson1, Katrina Fernandez1,2, Cesar Lopez1
1Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
Arxiv
|June 29, 2026
Summary
Accurate measurement of spinal cord stimulator leads is crucial for chronic pain management. This study developed a validated radiographic technique to precisely track lead placement, ensuring treatment efficacy and minimizing complications like migration.
Area of Science:
- Neurosurgery
- Pain Management
- Medical Imaging
Background:
- Spinal cord stimulation (SCS) is a key therapy for chronic pain.
- Lead migration is a frequent complication, reducing SCS treatment effectiveness.
- Existing radiographic methods for assessing lead migration lack consistency and validation.
Purpose of the Study:
- To develop and validate a radiographic technique for measuring epidural spinal cord lead positions.
- To establish the accuracy, repeatability, and reproducibility of this measurement method within the lumbosacral spinal canal.
Main Methods:
- Computed tomography (CT) scans from three participants with implanted SCS leads were used.
- Three-dimensional measurements determined electrode positions from CT data.
- Digitally reconstructed radiographs (DRRs) were generated for analysis.
- A digitization and measurement protocol was applied by two operators.
- Bland-Altman analysis and Gage Repeatability and Reproducibility (GRR) analysis were performed.
Main Results:
- The developed method achieved a smallest detectable change (SDC) less than the distance between adjacent electrodes.
- Variability from repeatability and reproducibility was less than 10% of total study variability.
- The technique demonstrated high accuracy and acceptable repeatability and reproducibility.
Conclusions:
- A validated radiographic technique for measuring spinal cord lead electrode position was successfully developed.
- The method offers sufficient accuracy and acceptable repeatability and reproducibility for clinical use.
- This technique can aid in monitoring lead placement and managing complications in SCS therapy.