gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Percutaneous implanted paddle lead for SCS: Technique and one year follow-up

Meeting Abstract

Suche in Medline nach

  • S. Schu - Abteilung für Stereotaxie und funktionelle Neurochirurgie, Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • J. Vesper - Abteilung für Stereotaxie und funktionelle Neurochirurgie, Neurochirurgische Klinik, Universitätsklinikum Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 021

DOI: 10.3205/11dgnc242, URN: urn:nbn:de:0183-11dgnc2429

Veröffentlicht: 28. April 2011

© 2011 Schu et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Spinal cord stimulation is an established method for the treatment of chronic pain. Cylindrical type leads can be implanted percutaneously. Most paddle type leads (lamitrodes) require more invasive surgery as laminotomy or laminectomy is necessary for placement into the epidural space. However, paddle type leads offer several advantages over cylindrical type leads, including less lead migration and better paresthesia coverage. The presented technique combines the advantages of both approaches. The goal of this study was to demonstrate the safety and efficacy of minimally invasive percutaneous implantation and advancement of a slim line paddle lead for SCS.

Methods: Data was collected prospectively. The patients were implanted with a slim line paddle lead using a novel introduction system for percutaneous implantation. All implantations were performed under local anesthesia. Prior to the final implantation of the IPG (Eon mini, SJM, Plano, TX, USA), all patients underwent seven days of trial stimulation. Median follow-up was nine months.

Results: 107 patients have been implanted so far. All suffered from failed back surgery syndromes with a combined leg and lower back pain. The data shows excellent clinical outcome for paresthesia overlap and pain reduction with a risk profile comparable to known percutaneous techniques (median VAS reduction 7 to 4). There were no major complications. Compared to the literature (up to 30%) the rate of lead migration was low (n = 5; 4%).

Conclusions: Our data indicates that this new minimally invasive percutaneous approach to be effective and safe. Placement is performed under local anesthesia, which allows for the intraoperative testing of the paresthesia coverage for optimal clinical outcome. The approach is less invasive. It offers a faster and more comfortable procedure.