gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Percutaneous implanted paddle lead for SCS: Technique and 2-year follow-up

Meeting Abstract

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  • S. Schu - Neurochirurgische Klinik, Zentrum für Neuromodulation, Heinrich-Heine-Universität Düsseldorf
  • T. Kinfe - Neurochirurgische Klinik, Zentrum für Neuromodulation, Heinrich-Heine-Universität Düsseldorf
  • C. Wille - Neurochirurgische Klinik, Zentrum für Neuromodulation, Heinrich-Heine-Universität Düsseldorf
  • J. Vesper - Neurochirurgische Klinik, Zentrum für Neuromodulation, Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.11.06

doi: 10.3205/12dgnc260, urn:nbn:de:0183-12dgnc2607

Published: June 4, 2012

© 2012 Schu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Spinal cord stimulation (SCS) 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. Yet paddle type leads offer several advantages, including less lead migration and better paraesthesia coverage. The study demonstrates the stable long-term results of minimal invasive percutaneous implantation and improvement of a paddle lead for Spinal Cord Stimulation.

Methods: Data was collected prospectively. The patients were implanted with paddle lead using an epiducer system for percutaneous implantation. All implantations were done under local anesthesia. Prior to the final implantation of the implantable pulse generator (Eon miniTM, St. Jude Medical Neuromodulation Division, Plano, TX), all patients underwent seven days of trial stimulation. Median follow-up was 12 months.

Results: 200 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 paraesthesia overlap and pain reduction in the legs and the back with a risk profile comparable to known percutaneous techniques (median VAS reduction 8 to 3). They were no major complications. Compared to the literature (up to 30%), the rate of lead migration was low (n = 6–3%).

Conclusions: Our data shows this meanwhile well-approved approach to be effective and safe. Placement is done under local anaesthesia, which allows an intraoperative paraesthesia testing for optimal clinical outcome. The approach offers a faster and more comfortable procedure.