gms | German Medical Science

Introduction: Spinal cord stimulation (SCS) has become an established treatment for various complex pain symptoms. SCS can either be performed by a percutaneous needle approach by which a cylindrical type of lead is inserted or by implanting a paddle type lead. The latter surgical procedure is much more invasive and requires laminectomy. However, traditionally the paddle type lead has been thought to be less affected by dislocation. Migration rates of up to 30% have been reported for percutaneously implanted electrodes. Over the last years several anchoring systems have been commercially available.. This study demonstrates migration to be a minor complication in percutaneously implanted electrodes if used with a proper anchoring system.

Material and methods: Data were collected prospectively. The patients were implanted with a hybrid lead using a Seldinger-style introduction system for percutaneous implantation and fixated with an anchoring system. Upon successful trial, final implantation of the internal pulse generator followed. Median follow-up was 36 months.

Results: 432 patients have been implanted so far. All suffered from failed back surgery syndromes with a combined leg and lower back pain. Rate of migration was 0.69% (n=3).

Conclusion: Our data shows percutaneously implanted electrodes in combination with an anchoring system to be very effective and less invasive than paddle type leads yet only minimally affected by lead migration.