Spinal Cord Stimulation Paddle-to-Percutaneous Revision: Case Series and Technical Description

World Neurosurg. 2024 Feb:182:e891-e898. doi: 10.1016/j.wneu.2023.12.080. Epub 2023 Dec 20.

Abstract

Objective: Spinal cord stimulators (SCSs) can be implanted via a percutaneous or paddle approach, the latter technique requiring a laminotomy or laminectomy. Revision surgery may be necessary in instances of migrated, misplaced, or failed stimulators. When revision of a percutaneous system is necessary, it is common to replace the electrodes with a paddle SCS. This study aims to describe a case series of patients with failed paddle SCS electrodes who underwent revision with percutaneous SCS hardware.

Methods: A series of 5 patients were retrospectively analyzed. Medical records were reviewed for demographic data, operative technique, postoperative follow-up, and complications.

Results: Five patients were included in this series. The median age was 63 (range 51-84), and the median duration from initial implantation to revision surgery was 19 months (range 5-60). The median operative duration was 92 minutes (mean 99 ± 19.6 minutes). The median length of follow-up after surgery was 24 months (mean 21.8 ± 6.0 months). All patients had improved pain relief and therapeutic coverage with no complications.

Conclusions: Paddle-to-percutaneous SCS surgery is a feasible and durable revision option in appropriately selected patients.

Keywords: Case series; Neuromodulation; Paddle; Pain; Percutaneous; Revision; Spinal cord stimulation.

MeSH terms

  • Electrodes, Implanted
  • Humans
  • Middle Aged
  • Pain Management / methods
  • Retrospective Studies
  • Spinal Cord / physiology
  • Spinal Cord / surgery
  • Spinal Cord Stimulation* / methods