دورية أكاديمية
Spinal Cord Stimulator Paddle Lead Revision and Replacement for Misplaced or Displaced Electrodes.
العنوان: | Spinal Cord Stimulator Paddle Lead Revision and Replacement for Misplaced or Displaced Electrodes. |
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المؤلفون: | Mong ER; Department of Neurosurgery, Beaumont Neuroscience Center, Royal Oak, Michigan, USA., Kethireddy S; Department of Neurosurgery, Beaumont Neuroscience Center, Royal Oak, Michigan, USA., Staudt MD; Department of Neurosurgery, Beaumont Neuroscience Center, Royal Oak, Michigan, USA; Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA. Electronic address: Michael.Staudt@UHHospitals.org. |
المصدر: | World neurosurgery [World Neurosurg] 2024 Jun; Vol. 186, pp. e432-e439. Date of Electronic Publication: 2024 Mar 30. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: New York : Elsevier |
مواضيع طبية MeSH: | Spinal Cord Stimulation*/instrumentation , Spinal Cord Stimulation*/methods , Reoperation* , Electrodes, Implanted*/adverse effects , Laminectomy* , Equipment Failure*, Humans ; Female ; Male ; Middle Aged ; Aged ; Retrospective Studies ; Adult |
مستخلص: | Objective: Spinal cord stimulators (SCSs) are commonly implanted via a laminotomy or laminectomy. Revision surgery may be necessary in instances of hardware failure or loss of efficacy. It is uncommon for leads to have been initially misplaced in a suboptimal position and revision in these cases necessitates additional dissection for appropriate repositioning. Accordingly, there is concern with a more extensive revision for a potentially higher risk of associated complications. This study aims to describe a series of patients with failed paddle SCS electrodes due to misplacement who underwent revision and replacement. Methods: Patients who underwent SCS paddle replacement for misplaced paddles between 2021 and 2023 were identified. Medical charts were reviewed for demographic data, operative details, and incidence of complications. Results: Sixteen patients underwent thoracic SCS paddle revision and replacement. The mean age was 59.6 ± 12.6 years, with 11 females and 5 males. Misplaced paddles were too lateral (n = 12), too high (n = 2), or incompletely within the epidural space (n = 2). The mean duration from initial implantation to revision surgery was 44.8 ± 47.5 months. The mean operative duration was 126.1 ± 26.9 minutes and all patients required a "skip" laminectomy or laminotomy. No complications were encountered. The mean length of follow-up was 18.4 ± 7.3 months. Mean preoperative pain intensity was 7.9 ± 1.5 and at last follow-up was 3.6 ± 1.7 (P < 0.001). All but 1 patient continued to use their device in follow-up. Conclusions: The revision and replacement of misplaced paddle SCS electrodes is a feasible and durable revision strategy, even in long-term implants with extensive scarring. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
فهرسة مساهمة: | Keywords: Case series; Neuromodulation; Paddle; Pain; Percutaneous; Revision; Spinal cord stimulation |
تواريخ الأحداث: | Date Created: 20240401 Date Completed: 20240608 Latest Revision: 20240626 |
رمز التحديث: | 20240626 |
DOI: | 10.1016/j.wneu.2024.03.154 |
PMID: | 38561030 |
قاعدة البيانات: | MEDLINE |
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