Rate of Complications Following Spinal Cord Stimulation Paddle Electrode Removal

被引:21
作者
Maldonado-Naranjo, Andres L. [1 ]
Frizon, Leonardo A. [1 ]
Sabharwal, Navin C. [1 ]
Xiao, Roy [1 ]
Hogue, Olivia [1 ]
Lobel, Darlene A. [1 ]
Machado, Andre G. [1 ]
Nagel, Sean J. [1 ]
机构
[1] Cleveland Clin, Ctr Neurol Restorat, Neurol Inst, 9500 Euclid Ave,S10-20, Cleveland, OH 44195 USA
来源
NEUROMODULATION | 2018年 / 21卷 / 05期
关键词
Complications; electrode paddle; electrode removal; paddle removal; spinal cord stimulation; LAMINECTOMY ELECTRODES; EPIDURAL HEMATOMAS; SURGERY; LEADS; IMPLANTATION; INFECTION; OUTCOMES; PAIN; PREVENTION; PLACEMENT;
D O I
10.1111/ner.12643
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
ObjectiveSpinal cord stimulation (SCS) is a safe, reversible surgical treatment for complex regional pain syndrome and failed back surgery syndrome refractory to conventional medical management. Paddle electrodes are routinely used for the permanent implant because of the reduced risk of migration, lower energy requirements, and expanded coverage options. The risks associated with paddle lead removal are not well defined in the literature. MethodsWe retrospectively reviewed the outcomes of all patients at the Cleveland Clinic who underwent removal of SCS paddle electrodes between 2009 and 2016. ResultsWe identified 68 patients during this interval who had a paddle electrode removed. The most common reason for removal was loss of coverage or effect (75%), followed by infection (13.24%), and the need for magnetic resonance imaging for diagnostic purposes (8.82%). Postoperative complications occurred in eight patients (11.75%), two of which were classified as major (2.94%). One of these patients developed a postoperative cerebrospinal fluid leak, and another suffered a large suprafascial hematoma. Both patients underwent reoperation. Minor complications were reported in six patients (8.82%) and included wound dehiscence, infection, and prolonged ileus in one case. On average, patients who developed complications lost 20 mL more blood during surgery than those who did not develop complications (p=0.006). ConclusionOne of the benefits of SCS therapy is the reversibility of the procedure. However, removal is not without some risk though the overall risk of minor or major complication is low. Patients who are considering removal should be counseled appropriately. Prophylactic removal is not recommended. However, when removal is needed, surgeons and pain specialists must be familiar with these complications and their management.
引用
收藏
页码:513 / 519
页数:7
相关论文
共 26 条
[1]   Spinal Cord Stimulation for Chronic Pain: Causes of Long-Term Paddle-Lead Failure [J].
Akmal, Samira ;
Eljamel, M. Sam .
NEUROMODULATION, 2008, 11 (04) :282-285
[2]   Spinal Epidural Hematoma After Spinal Cord Stimulator Trial Lead Placement in a Patient Taking Aspirin [J].
Buvanendran, Asokumar ;
Young, Adam C. .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2014, 39 (01) :70-72
[3]   Predictors of Spinal Cord Stimulation Success [J].
De La Cruz, Priscilla ;
Fama, Christopher ;
Roth, Steven ;
Haller, Jessica ;
Wilock, Meghan ;
Lange, Steven ;
Pilitsis, Julie .
NEUROMODULATION, 2015, 18 (07) :599-602
[4]   The Neurostimulation Appropriateness Consensus Committee (NACC) Safety Guidelines for the Reduction of Severe Neurological Injury [J].
Deer, Timothy R. ;
Lamer, Tim J. ;
Pope, Jason E. ;
Falowski, Steven M. ;
Provenzano, David A. ;
Slavin, Konstantin ;
Golovac, Stanley ;
Arle, Jeffrey ;
Rosenow, Joshua M. ;
Williams, Kayode ;
McRoberts, Porter ;
Narouze, Samer ;
Eldabe, Sam ;
Lad, Shivanand P. ;
De Andres, Jose A. ;
Buchser, Eric ;
Rigoard, Philippe ;
Levy, Robert M. ;
Simpson, Brian ;
Mekhail, Nagy .
NEUROMODULATION, 2017, 20 (01) :15-30
[5]   Epidural Hematomas After Removal of Percutaneous Spinal Cord Stimulator Trial Leads Two Case Reports [J].
Giberson, Curren E. ;
Barbosa, Judith ;
Brooks, Elizabeth S. ;
McGlothlen, Gail L. ;
Grigsby, Eric J. ;
Kohut, James J. ;
Wolbers, Linda L. ;
Poree, Lawrence R. .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2014, 39 (01) :73-77
[6]   Technique, Results, and Complications Related to Robot-Assisted Stereoelectroencephalography [J].
Gonzalez-Martinez, Jorge ;
Bulacio, Juan ;
Thompson, Susan ;
Gale, John ;
Smithason, Saksith ;
Najm, Imad ;
Bingaman, William .
NEUROSURGERY, 2016, 78 (02) :169-179
[7]   Effect of fibrin glue on the prevention of persistent cerebral spinal fluid leakage after incidental durotomy during lumbar spinal surgery [J].
Jankowitz, Brian T. ;
Atteberry, Dave S. ;
Gerszten, Peter C. ;
Karausky, Patricia ;
Cheng, Boyle C. ;
Faught, Ryan ;
Welch, William C. .
EUROPEAN SPINE JOURNAL, 2009, 18 (08) :1169-1174
[8]   Percutaneous Implanted Paddle Lead for Spinal Cord Stimulation: Technical Considerations and Long-Term Follow-Up [J].
Kinfe, Thomas M. ;
Schu, Stefan ;
Quack, Florian J. ;
Wille, Christian ;
Vesper, Jan .
NEUROMODULATION, 2012, 15 (04) :402-407
[9]  
Kueper Janina, 2016, HSS J, V12, P186, DOI 10.1007/s11420-016-9496-6
[10]   Incidence and Avoidance of Neurologic Complications with Paddle Type Spinal Cord Stimulation Leads [J].
Levy, Robert ;
Henderson, Jaimie ;
Slavin, Konstantin ;
Simpson, Brian A. ;
Barolat, Giancarlo ;
Shipley, Jane ;
North, Richard .
NEUROMODULATION, 2011, 14 (05) :412-422