The Efficacy of High-Density Spinal Cord Stimulation Among Trial, Implant, and Conversion Patients: A Retrospective Case Series

Abstract Background Failed back surgery syndrome (FBSS) is a common problem affecting 20–40% of cases undergoing spine surgeries. Spinal cord stimulation (SCS) has been shown to be an efficient and relatively safe treatment in managing many intractable chronic pain syndromes. Objectives This study compares the efficacy and safety of MR-compatible sensor driven-position adaptive SCS and conventional SCS in treating FBSS. Methods This is a retrospective case series of 120 consecutive FBSS patients who underwent SCS between February 2011 and March 2018. Pain levels, analgesic/opioid use, and sleep problems were assessed before and 3 months after the procedure in patients who received either conventional SCS (group 1; n = 62) or sensor-driven position adaptive SCS (group 2; n = 34). The degree of patient satisfaction, the change in the activities of daily living (ADLs) together with the rate of complications were compared in both treatment groups. Results The two treatment groups were homogenous at baseline. Patients in both groups improved significantly regarding pain, opioid consumption, sleep, and ADLs. The magnitude of improvement was statistically higher in group 2. An absolute reduction of 6 points on the VAS in patients who received position adaptive SCS vs a 3.3 point reduction in conventional SCS cases (p < 0.0001). Half of the patients in group 2 (n = 17) showed excellent satisfaction after the procedure versus 14.5% of cases in group 1 (n = 9). Conclusion SCS is an efficient and reliable treatment in FBSS. MR-compatible sensor driven-position adaptive SCS can be a more effective treatment in this patient group.

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Paresthesia-Free High-Density Spinal Cord Stimulation for Postlaminectomy Syndrome in a Prescreened Population: A Prospective Case Series

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.12357 ◽

2015 ◽

Vol 19 (3) ◽

pp. 260-267 ◽

Cited By ~ 31

Author(s):

Jennifer Sweet ◽

Anish Badjatiya ◽

Daniel Tan ◽

Jonathan Miller

Keyword(s):

Spinal Cord ◽

Spinal Cord Stimulation ◽

Case Series ◽

High Density ◽

Prospective Case Series

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A Retrospective Case Series of a Novel Spinal Cord Stimulator Trial Technique with Less Displacement and Migration of the Trial Leads

Pain Research and Management ◽

10.1155/2019/1236430 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

N. Shaparin ◽

K. Gritsenko ◽

P. Agrawal ◽

S. Kim ◽

S. Wahezi ◽

...

Keyword(s):

Spinal Cord ◽

Case Series ◽

Small Sample ◽

Spinal Cord Stimulator ◽

Retrospective Case ◽

Thoracic Spinal Cord ◽

Retrospective Case Series ◽

Lead Placement ◽

Spine Pathology ◽

And Migration

Background. Spinal cord stimulation is an established treatment option for certain chronic pain conditions which have been previously unresponsive to conservative therapies or potentially for a subset of patients who have not improved following spine surgery. Prior to permanent lead implantation, stimulator lead trials are performed to ensure adequate patient benefit. During these trials, one of the most common complications and reasons for failure is the displacement and migration of the trial leads, resulting in lost therapeutic coverage. Other complications include infection and dislodged bulky dressings. There is a paucity of literature describing an adequate procedural method to prevent these common complications. Objective. This study utilizes a series of 19 patients to evaluate a new technique for securing percutaneous spinal cord simulator trial leads, which may minimize dislodgement and migration complications and improve the rate of trial success. Study Design. Retrospective case series. Setting. New Jersey Medical School, Department of Anesthesiology, Pain Management Division. Methods. A retrospective chart review was conducted on 19 consecutive patients undergoing placement of the percutaneous thoracic spinal cord stimulator trial leads for pain associated with lumbar spine pathology over a two-year period (2010–2012). Results. Of the 19 patients in our cohort, there was one trial lead displacement, no lead migrations, and no site infections. Thirteen patients went on to permanent lead implantation. This improved trial lead placement technique had a high success rate with a low number of complications. Limitations. Small sample size, retrospective case series, and no control group for comparison. Conclusion. This case series was able to demonstrate that our described novel spinal cord stimulator trial lead placement and dressing technique can decrease the incidence of lead displacement and migration, thus improving trial success.

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